For Asians, there are two biggest problems with the nose: one is that the height is not enough, and the other is that the nose is too round and blunt.
A wide nose can make people look rustic and clumsy! Others will give people a stubborn and annoying feeling!
Usually, the wide nose and nose have the problem of insufficient height!
Let's take a look at the standard nose:
Width: The width of the base of the alar should be approximately equal to the distance between the inner canthus of two eyes, that is, the distance of one eye. If the bottom of the nose wing is slightly wider than the width of the eyes. Then, we should consider cutting off the base of the alar and reducing the alar.
Height: Generally speaking, it conforms to the aesthetics of nose looking down, and the nose column and base should form an approximate equilateral triangle (as shown below). For westerners, the length of the lobule under the tip of the nose: the length of the columella = 1:2, but according to my surgical experience, 2:3 is more in line with the natural aesthetics of the orientals.
If the columella is too short and the nasal septum is underdeveloped, the nose will collapse and the alar will span to both sides, which will visually cause the alar to be wide. Under the same alar base width, columella will have an absolute influence on alar width! Please refer to the following figure:
According to the causes, I divide the width of the alar into three types: false, true and visual:
A, false armpit width:
In fact, a considerable number of beauty seekers who require simple alar reduction surgery are not ideal candidates for alar reduction surgery. These beauty seekers are all caused by the height difference of the nasal tip, which can be improved by improving the nasal tip. For example, just like two tents of the same size, the higher the tent, the smaller the area, and the shorter the tent, the larger the area.
It is caused by thick subcutaneous fat and fibrous tissue in the nose and head, hyperplasia of alar cartilage, excessive separation angle of alar cartilage on both sides, and retraction of lateral alar cartilage.
After removing the hypertrophic inferior nasal cartilage, suture the inferior nasal cartilage on both sides to round the tip of the nose into an ideal shape. At the same time, the thick subcutaneous tissue and fat of the nose should be fully removed, and nasal plastic materials can be used to raise the tip of the nose when necessary.
The height of the nose is relatively low, and the length of the columella is not enough. In this case, the columella can be extended by padding the tip of the nose or inserting auxiliary materials of the columella. After the height increases, the nose will contract and it will not look so wide!
Note: the tension of the skin has not changed. The skin itself has certain extensibility. The greater (tighter) the skin tension, the smaller the ductility and the greater the operation limitation. You have to accept that the bridge of the nose and the tip of the nose may not reach the ideal height. If you are greedy for heights and tips, the transplanted materials will push the skin to the limit, resulting in complications such as transparent skin and redness.
Second, the authenticity of the nose width:
If the alar width is obvious and the skin tension is limited, the nasal tip can be raised at the same time. Combining with the surgical incision or external incision, the reason for choosing which resection method needs to determine the alar width, which is more tissue or the alar base width.
The alar is enlarged and the alar tissue is moderately thickened, but the nostril size and nasal threshold are basically normal:
External incision: make a crescent-shaped tissue incision on the outside of the alar and take out a wedge-shaped tissue. Generally, the notch width is less than 3mm, the front end is less than the leading edge of the alar, and the incision depth is less than the thickness of the alar.
The nose is too big, and the alar tissue hypertrophy is not obvious;
Internal cutting: it is to cut off a piece of tissue in the nostril, narrow the nostril and reduce the expansion of the alar.
This situation is very rare and not suitable for beauty seekers with basically normal nostril size. Because internal cutting will lead to too small nostrils, which will affect nasal ventilation in severe cases.
The alar is enlarged and the nostrils are too large.
Internal cutting and external cutting coordination: according to the degree of alar hypertrophy and nostril oversize, adjust the amount of internal cutting and external cutting tissue.
Hyperhypertrophy of alar tissue
Longitudinal section: alar hypertrophy means that the soft tissue at the alar edge is thicker. The only way to improve this situation is to thin the alar and have it removed. Generally, an incision is made above the nasal vestibule or at the base of the lateral alar to secretly separate the alar margin. In other words, the longitudinal shear reduces the thickness of the alar, and then combines the internal shear and the external shear.
Third, the visual nose width:
Nose retraction: the nose retracts and the nostrils are obviously exposed, forming the so-called "nose facing the sky", which visually leads to a larger nose wing. This will lengthen the nose and make the alar look small and natural.
Although the alar reduction surgery does not seem complicated, there are many surgical techniques, such as the design of the incision: is it along the nasal groove? Or is it from the nasal sulcus 1mm? Is the incision a straight line when it passes through the nostril edge and the nasal threshold? Or a curve? The length of the incision and so on. If not handled properly, it is likely to lead to very ugly deformity.
Note: The above pictures are partly from the Internet and are for reference only.