LAM FACIAL PLASTICS

Dr. Lam,

I like the size and shape of my nose, but I don't like how my nostrils flare up even when they are relaxed. Is it possible to reduce only nostril flare, and what are special risks associated with this surgery? I've never had any reconstructive facial surgery before. Do you often treat patients for nostril reduction/flare reduction who also do not want anything done to the rest of their nose?

Thanks for the info!

yes, i have done this in very select patients. the risks of only nostril flare reduction are as follows:
1. not enough change to the nose to make it look better.
2. making the central tip look bigger and worse because the tip is bigger than the sides and the person thinks the sides are bigger than the tip. the best way to get an idea of that is to squeeze in the sides to the desired amount and see if the central tip looks a lot bigger. if so, then you have miscalculated what you need. every part of the nose needs to be in balance.
3. reducing just the nasal sill (the part of the nostril that runs on the face like a window sill) can reduce the nostril width and typically does not lead to much recovery time but done alone in a patient can make the nostril smaller but rounder.
4. an alar base reduction done outside can reduce the flare but not the nostril width. the major problem with this is notching the nostril if not done with a Sheen flap making it look like the pinched Michael Jackson look. also, the risk of prolonged scarring done on the outside of the nose. that can take a year to look normal. also there may always be a little evidence of the incision, i.e., the outer alar base incision may always show a small line there because that one area of the nose does not heal that well.