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Wide Nasal Tip / Wide Nostrils
A broad tip can result from either a wide nasal base or a bulbous (excessively rounded) tip. Thick skin and curved nasal cartilages may result in a bulbous nasal tip which is treated by refining the cartilage to achieve a more defined tip outline.
The outer part of the nostril region (known as the ala) contains no cartilage. In fact, only a small area in the lower third of the nose is occupied by the white cartilage. The outer part and sidewalls consist of fibro-fatty tissue. Individuals with broader noses have an increased fibro-fatty tissue.
Wide/Broad Nostrils can also be a concern especially in Māori/Pacific Islanders/African population and is commonly addressed through techniques like wedge excision and small skin excision.
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Wedge Excision (Weir Excision)
Wedge Excision (Weir Excision) is a surgical technique used to reduce the width of the nostrils or reshape the nasal base by removing this fibrofatty tissue from the area adjacent to the nostrils, particularly around the alar-facial groove. A wedge-shaped incision is carefully designed in the crease where the nostril meets the cheek.
There are different types of wedge excisions depending on the desired outcome. Outer Wedge removes excess tissue on the outer part of the nostril without altering the internal nostril size while a Combined Wedge reduces both the external tissue and the size of the internal nostril opening. It is frequently combined with procedures that reduce the overall size of the nose. This can sometimes result in the alar base appearing disproportionately large after making the upper two-thirds of the nose smaller.
The scar from a wedge excision is concealed within the crease between the nostril and the cheek and lip. It involves two layers of sutures: a deep layer that dissolves over time and a skin layer that is removed about one week after surgery.
Nasal Sill Excision
Alternatively, it is also possible to remove skin only from the floor of the nose to help narrow a wide nasal floor or reduce nostril flaring in this procedure. Careful stitching is crucial to ensure these areas heal well and remain inconspicuous.
Combination
For patients with very wide nostrils, a combined wedge and nostril sill excision may be recommended to achieve the desired aesthetic outcome.
