When the nose is viewed from underneath, the nostrils and the tip of the nose would appear as a triangle known as the pyriform aperture.

To decrease the nose’s width, a surgeon will make adjustments to the pyriform aperture. By making this triangle’s angles steeper at the point where the nostrils meet the face, a surgeon can efficiently decrease nose width.

Experienced facial plastic and reconstructive surgeon Dr. Eric Yavrouian provides nose width reduction cosmetic surgery procedures to patients in Glendale, Pasadena, Burbank, Greater Los Angeles, Beverly Hills, CA, and surrounding locations in this region of SoCal.

What is Nasal Base Reduction?

A nasal base reduction is a rhinoplasty maneuver that helps narrow the nose base in instances where it is too broad for the facial structure. The reduction of the nasal base in some variation is standard in rhinoplasty and revision rhinoplasty.

In the case of ethnic rhinoplasty, it is even more common. For instance, rhinoplasty on Asian, African American, and Middle Eastern noses frequently involves reducing the nasal base. These ethnicities tend to have a broader nasal base warranting a nasal base reduction to refine the nose.

The primary complaint of a majority of patients seeking rhinoplasty and revision rhinoplasty is that their nose appears too broad or big at the bottom. The adjacent image depicts the nasal base region highlighted in red. The base is usually measured from the outer margin of one nostril to the outer margin of the other nostril.

Effectively, the nasal base width should not be more than the distance between the two eyes. If you were to run a vertical line down from the inner canthus (corner of the eye) on either side, the base of the nose should fall between these two lines.

But it is important to note that this adjustment is an aesthetic ideal for a Caucasian nose. This may not be the goal in case of ethnic noses. In case of many ethnic rhinoplasty candidates, if the base of the nose is slightly broader than this measurement, it will offer a more natural looking outcome.

Anatomy Involved in Nasal Base Reduction

A thorough understanding of the anatomy of the nasal base area is vital to decide on the surgical treatment of specific rhinoplasty patients. The columella is a structure that resembles a column situated in the middle of the nasal base.

It divides the nostrils into right and left parts. The alar base insertion is the segment of the nostril side wall that inserts into the upper lip-cheek junction. The nasal sill area is the area between the alar base insertion point and the columella.

A Wide Sill Area

Certain rhinoplasty patients with a wide nasal base also have a very wide sill region that adds to the extra nose width. In case the sill region is too wide, it could lead to a more horizontal type nostril shape. This is common in patients that have a wide nasal sill.

Cordial facial plastic and reconstructive surgeon Dr. Eric Yavrouian receives patients from Glendale, Pasadena, Burbank, Greater Los Angeles, Beverly Hills, CA, and other communities and neighborhoods in this part of the southwest for rhinoplasty.

For more information about treatments and procedures by Facial Plastic and Reconstructive Surgeon, Dr. Eric J. Yavrouian, serving patients in and around Glendale, Pasadena, Burbank and the Greater Los Angeles, CA area call 818-241-2150 or click here to contact him for a consultation.

One of the surgical maneuvers in rhinoplasty involves ‘deprojection’ of the nasal tip. Notably, only surgeons who are truly specialist’s in rhinoplasty and revision rhinoplasty cosmetic surgery should employ this technique.

Deprojection means the reduction of the nasal tip projection to make the nose appear more harmonious and proportionate with the rest of the face.

Experienced facial plastic and reconstructive surgeon Dr. Eric Yavrouian provides nose projection adjustment procedures to patients in Glendale, Pasadena, Burbank, Greater Los Angeles, Beverly Hills, CA, and surrounding locations in this part of the country.

What is Nasal Tip Projection?

The nasal tip projection essentially means how far out the tip protrudes from the face when the profile is viewed. It is the distance that it extends outward from where it meets the upper lip to its tip. In case this tip projects too far out, it can significantly impact the appearance of the nose.

Conversely, under-projected noses may appear too shallow which can make the nose look quite small in proportion to other features of the face.

How the Projection is corrected?

The surgeon may trim a part of the cartilage at its tip to decrease the nose projection. The surgeon may detach and realign the patient’s cartilage, push it forward, suture it into a refined position to increase the projection of the nose tip. In case the cartilage is not available sufficient amount in the nose tip, the surgeon might utilize a cartilage graft perform this procedure.

Rhinoplasty for an Over-Projected Tip

The key goal in rhinoplasty cosmetic surgery for an overly projected nasal tip is to bring the nasal tip closer to the face (deprojecting the nasal tip) while preserving the proportion with the rest of the nose and facial features. The height of the bridge is often quite high in patients with an overly projected nasal tip.

This means that it may be necessary to decrease the bridge height while drawing the tip of the nose closer to the face.

In certain rhinoplasty cases, deprojection of the nasal tip merely means decreasing the size of the domal cartilage. The domal cartilage is the highest point of the lower lateral cartilage as it projects from the face. In case this part of the lower lateral cartilage is too substantial, the surgeon can meticulously reduce the dome to deproject the nasal tip.

Specific rhinoplasty terminologies that pertain to this form of nasal tip deprojection technique include crural overlay, domal truncation, and vertical dome division. In other rhinoplasty cases, the surgeon detaches the complete lower lateral cartilage, moves it, and re-attaches it to attain the desired alteration in the projection on the tip.

According to the rhinoplasty surgeon’s skills and experience, both techniques can be effectively utilized through the open or closed rhinoplasty approach.

In many cases where the nasal tip is being deprojected, the nose also requires slight rotation to preserve the correct aesthetic balance. To a certain degree, this rotation is directly proportional to the level of tip deprojection being done.

Focused facial plastic and reconstructive surgeon Dr. Eric Yavrouian receives patients from Glendale, Pasadena, Burbank, Greater Los Angeles, Beverly Hills, CA, and other towns and communities in this part of the southwest for rhinoplasty.

For more information about treatments and procedures by Facial Plastic and Reconstructive Surgeon, Dr. Eric J. Yavrouian, serving patients in and around Glendale, Pasadena, Burbank and the Greater Los Angeles, CA area call 818-241-2150 or click here to contact him for a consultation.

The nasolabial angle comprises of two lines. The first one runs from the nasal tip to the region above the upper lip. The second line runs from the upper lip to the base of the nose, where the nostrils are divided. Nose projection and nose tip rotation can impact the degree of this angle.

In most cases, the surgeon seeks to produce a 90 to 95 degree nasolabial angle in male candidates, and a 100 to 105 degree angle in female candidates. The surgeon can refine this angle using a combination of rotation adjustments and projection techniques.

Sagacious facial plastic and reconstructive surgeon Dr. Eric Yavrouian provides nasolabial angle adjustment surgery to patients in Glendale, Pasadena, Burbank, Greater Los Angeles, Beverly Hills, CA, and surrounding communities across the horizon.

Correcting Nose to Lip Angle and Bulbous Tip

The surgeon may use a full delivery technique to correct a bulbous tip. They may suture the dome to the lower lateral cartilages while possibly adding a cartilaginous strut graft if required for support. Wide and large nostrils can be addressed through alar-based excisions if required. Any form of acute angle to the lip can be corrected by elevating the tip, reducing the caudal membranous and cartilaginous septum.

Alternative techniques to address this condition include taking down some anterior septal angle to enable upward tip rotation and techniques that change the tip itself or tripod of the nose and lengthen the medial crus or columella so that it projects upward and rotates.

The surgeon may decide to shorten the lateral or gull wing aspects of the tip cartilages. These approaches can be used in combination to narrow the tip and enhance the columellar labial angle at the simultaneously. Lastly, the surgeon can perform the alar base reduction together with a rhinoplasty as well as narrow the base to decrease its width.

There are various alternatives to address the angle between the lip and the nasal columella. Caudal extension grafts, as well as plumping grafts, developed to project the nasolabial angle can be effective. The creation of proper tip rotation is a standard facet of rhinoplasty. It is frequently used in combination with developing better tip definition. However, the definition is limited by thicker skin.

The surgeon may also employ trimming the septum at the anterior angle. But a particular recommendation on this technique would warrant an actual nose exam.

Lifting a Drooping Nose Tip

In patients who have thick skin and heavy noses, the tip frequently droops. There are various techniques to raise the nose tip. The surgeon can decrease the length of the septum. However, a majority of heavy noses need extra tip support. The surgeon achieves this through the use of cartilage grafts to provide strength to the tip and push it upwards.

If a patient has not had nose surgery previously, the ideal source of this graft material is the nasal septum. The tip cartilages can be made narrower also. For excessively thick skin and more strength, a graft using the patient’s cartilage, known as an extended shield graft, is frequently utilized as well.

Accomplished facial plastic and reconstructive surgeon Dr. Eric Yavrouian receives patients from Glendale, Pasadena, Burbank, Greater Los Angeles, Beverly Hills, CA, and other towns and suburbs in The Golden State for rhinoplasty.

For more information about treatments and procedures by Facial Plastic and Reconstructive Surgeon, Dr. Eric J. Yavrouian, serving patients in and around Glendale, Pasadena, Burbank and the Greater Los Angeles, CA area call 818-241-2150 or click here to contact him for a consultation.

One of the aesthetic goals in many rhinoplasty cosmetic surgery procedures is to rotate the tip. Rotation of the tip means that the angle that the tip makes as it comes away from the face is altered. Rotating the tip refers to tilting it upwards while de-rotating involves tilting the tip downwards.

In many cases, as the nose tip cartilages become softer, they have a tendency to tilt downward. Therefore, a majority of patients ask for an upward tip rotation. This alters the angle between the lip and nose without necessarily causing changes to the tip length regarding its distance from the nose.

The most suitable tip position depends on various factors such as an individual’s ethnicity, gender, and height of the nose. For instance, surgeons commonly seek to tilt the nose tip up in women more so than in men as a slightly upward rotated tip is a more feminine characteristics.

Experienced facial plastic and reconstructive surgeon Dr. Eric Yavrouian provides nose tip rotation and reduction surgery to patients in Glendale, Pasadena, Burbank, Greater Los Angeles, Beverly Hills, CA, and surrounding locations.

Customization

The tip of the nose is considered a distinct area of the of the rhinoplasty surgery due to its animation and mobility. The goal is to design a defined, stable, and correctly projecting tip that is symmetric on frontal and basal views, triangular on basal view, and appears natural and proportional with other facial features.

Every person has a unique nasal structure and anatomy. Therefore, no single nasal tip refinement technique suffices for numerous anatomical variations. Therefore, the surgeon will customize the procedure according to the patient’s specific requirements.

Surgical Objectives

The primary goal is to satisfy the patient’s cosmetic, functional, and psychological desires for the procedure.

• The surgeon will seek to refine the nasal lobule to make it more symmetrical and harmonious with the other nasal characteristics.
• The columella should be symmetric and it should have the correct relationship with the alar margins.
• There should be an appropriate nasal base width and nostrils should be of proper size and shape.

Possible Corrections

Tip rhinoplasty or corrective nose cosmetic surgery can help address the following conditions:

• Lifting a drooping nose
• Correcting a bulbous tip
• Rebalancing nostrils
• Decreasing nostril flare
• Previous rhinoplasty revision
• Straightening an unattractive curve
• Nostril rebalancing plastic surgery

Flared Nostrils

To correct excessively flared nostrils, the surgeon will place an incision at the nostril’s base and then use sutures to decrease the ‘flare’.

Wide Area between the Nostrils

At times, the area between the nostrils is excessively wide. The means the nose has what is known as “a wide base”. In this case, the surgeon will place an incision the nostrils’ base and use sutures to bring the nostrils closer together.

Other types of nostril and tip refinements can also be performed. However, you must consult an expert plastic surgeon who can offer you the right advice on possible nasal corrections through nose surgery or tip-only rhinoplasty surgical procedures.

Dedicated facial plastic and reconstructive surgeon Dr. Eric Yavrouian receives patients from Glendale, Pasadena, Burbank, Greater Los Angeles, Beverly Hills, CA, and nearby areas for rhinoplasty

For more information about treatments and procedures by Facial Plastic and Reconstructive Surgeon, Dr. Eric J. Yavrouian, serving patients in and around Glendale, Pasadena, Burbank and the Greater Los Angeles, CA area call 818-241-2150 or click here to contact him for a consultation.