One of the surgeries I perform most frequently in my practice is rhinoplasty—and one of the most common complaints I hear from my rhinoplasty patients is that their nostrils are too wide or flared.
There are two ways to surgically narrow wide nostrils: by removing a small wedge of tissue from the crease of the nostril (where it meets the face), or by performing a technique called a Weir excision, which involves removing a small wedge of tissue from the “alar base” (the base of the nostril). A Weir excision can narrow your nostril bases, reduce the length of your nostril sidewalls, and make your nostrils smaller, while still hiding the scar on the inside part of the nostril.
Nostril reduction can be performed alone or together with a full rhinoplasty. If it’s going to be performed in conjunction with tip surgery on the nose, the tip should be operated upon first, because the position of the tip affects the shape of the nostrils. Extending the tip of the nose can narrow the nostrils, while bringing the tip in closer to the face can widen the nostrils. If the nose is brought in especially far, the nostrils may even flare so much that they begin to buckle outward. This can be remedied with a Weir excision or by an excision from the crease of the nose, depending on the patient.
A nostril reduction may not sound particularly complicated, but don’t be fooled by the seeming simplicity of the procedure; determining how much tissue to remove and where to do it requires knowledge and skill, and a poorly done excision can leave you with noticeable scars, asymmetrical nostrils, or overly narrow nostril openings. If you think your nostrils are too wide, see a plastic surgeon who has extensive experience with rhinoplasties!