Rhinoplasty Types: Different Approaches to Nose Surgery

While your nose may seem like a straight (or bumpy, in some instances) piece of bone covered in cartilage and skin, it can be much, much more complicated than this. Here's what you need to know about rhinoplasty types.

Problem: Your Nostrils Are Too Wide

Solution: Alar Base Reduction

Alar base reduction is a surgical technique used for patients who come to a surgeon and feel as if their nostrils are too wide and/or flaring. The alar base is the section of your nose you feel when you place your finger flat against your nostrils. Surgery to correct the alar base is an instance of how each part of your nose affects the other. To correct the nostril flaring, your surgeon can use different surgical incision approaches, including:

Problem: The Tip of Your Nose Is Too Wide/Upturned/Downturned

Solution: Nasal Tip Plasty

Nasal tip plasty is a precise and intricate approach that can alter the tip of your nose. When performed in combination with other approaches, nasal tip plasty must be conducted before altering the nasal hump or bridge. Your surgeon will remove extra cartilage from the underside of your nose, just around the nostrils. Just how much cartilage is removed depends upon your desired results.

The nasal tip is one area subject to trends over the years, according to A. Dean Jabs, MD, Ph.D., FACS, an American Board of Plastic Surgery-certified plastic surgeon practicing with Cosmetic Surgery Associates, P.A., based in Bethesda, Md., and McLean, Va.

“People’s conception of what an attractive nose is can change,” Dr. Jabs says. “While patients a decade okay wanted a slight rise at the tip of the nose, today’s patients tend to want very little rise.”

Problem: Your Nose and/or Nostrils Are Too Wide

Solution: Reduction Rhinoplasty

Sometimes rhinoplasty does not require actual cutting of skin, but instead for reducing the nasal bones underlying your nasal frame. This is the case with reduction rhinoplasty, which involves approaching the nasal bones via cuts made inside your nostrils. Your surgeon will make cuts to the line on your nose and then brings the nasal bones together to reduce your nose’s overall size. Because your skin is so elastic, the skin will adjust to your new, smaller nose.

This approach is similar to a procedure that can be used to correct your breathing called septoplasty, where your surgeon adjusts the bones that separate your nostrils. When you have a condition called a deviated septum, this middle portion is misaligned, which can affect your breathing through one of your nostrils. Septoplasty can be performed alongside reshaping of the nose, if desired.

Problem: You Have a “Bump” on Your Nose

Solution: Dorsal Hump/Bump Reduction

One of the most common rhinoplasty types, the dorsal hump reduction removes a bump of area of unevenness along the line of your nose. While your surgeon may use a variety of techniques depending on the severity of the nasal hump, the procedure generally involves separating the cartilage from your bone and reducing the underlying bone. Your surgeon also may take out some cartilage if needed to maintain the nose’s natural appearance.


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