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Old 04-18-2010, 04:35 AM   #1
 
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Default Alar Retraction/Tip Refinement

I've always been very self concious of my retracted nostrils. I hate the columella show- especially from the right side! Also, I hate how large/flared the nostrils look from the frontal view (like a "V"). In what way is this normally treated? It is possible to have the surgery under local? The last image is what I would like to have. Thank you.
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Old 04-18-2010, 06:52 AM   #2
 
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Welcome to the forum!!!

To achieve the results you desire, the tip will have to be refined, which will affect the projection of your nose as well. You need a surgeon that is well versed in tip reconstruction and/or refinement.

You can be born with alar retraction, however, rhinoplasty or tauma are the more common ways that cause this condition. Trauma to the lower nose can also result in retraction. Did you ever break your nose or have any nasal trauma? How is your breathing?
Retraction is present in your case, but it is not as obvious as some I have seen. When people are not born with rim retraction it can be caused by excision, cartilage division, excision of too much alar sidewall mucosa, and/or alar skin excision. When someone is born with alar retraction, it can be due to over-arching alar cartilages that are usually long and plunging, or due to alar cartilage not being in the right spot. Localized skin flaps with or without cartilage grafting can be used to restore form and function.

Overdeveloped quadrangular cartilage with alar retraction can further exaggerate the amount of columellar show, which is what you're complaining about.

General anesthesia would be recommended for your procedure. Local anesthesia is used for minor alterations.

You have great eyes, eyelashes, and lips. I really like the black and white photo of you, where your entire face is visible. There is a dramatic heir about it, and you look lovely in it!


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Old 04-18-2010, 07:38 AM   #3
 
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Wow, thank you SO much for your detailed response- it is greatly appreciated! I haven't had trauma to the nose; I've had this problem my whole life. The nostril that is more retracted (right side), is the side which I have more trouble breathing from. Is it really possible that retracted alar can cause breathing difficulties?

It is a bit disheartening to hear that it would need to be general. It makes it seem like something so serious! Thank you for the compliments and thanks again for your help!

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Old 04-18-2010, 07:54 AM   #4
 
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Yes, alar retraction can cause nasal airway obstruction. If you can prove that you have had this issue since birth through medical records and/or documentation, insurance may cover the cost or a portion of the cost.

Local anaesthesia is only used for extremely minor cosmetic surgeries. Some surgeons give the patient an option when the procedure at hand is not too time consuming or severe. Like I said due to the fact that you require something other than a minor surgery, general anaesthesia should be utilized. It does not mean that your procedure is "so serious", but lets face it ... this is your nose!!! When you want it done, you want it done properly. You also do not want to be in any more pain that you have to be in!

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Old 04-18-2010, 10:50 PM   #5
 
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I totally understand what you don't like, but I do want you to know that your nose is better than average IMO You're a beautiful girl!

I wouldn't consider myself an expert on rhinoplasty, but I believe you would need something along the lines of a support graft to correct that alar retraction. The columella shouldn't be that difficult but tips always can be.

And yes, general will be necessary. As Robyne pointed out, it's only very minor procedures they don't use it... almost every type of rhinoplasty involves general.

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