Wide Nasal Base (Nostrils) - Nose Surgery

The nasal base refers to the region of the nose where the nostrils meet the face. The nasal base is comprised of the alar insertion, the nasal sill, and the columella.

Patients often complain of “wide nostrils.” It is important to understand the general guidelines for nostril width, or nasal base width. The nostrils ideally should not go past a plumb line drawn tangent to the medial canthus (the center-most portion of the eye).

In most cases,wide nostrils are due to a wide nasal sill. The nasal sill can be narrowed by performing a “sill excision.” This is also called a Weir excision.  It generally involves leaving a small linear scar that is well camouflaged in most patients. The surgeon must be careful to correctly diagnose the cause of “wide nostrils.” If the nasal sill is actually narrow and additional tissue is removed, the patient can develop external nasal valve collapse and the nostrils may adapt an unnatural shape. In some cases, it is the alar insertion that is wide  or flared, and the patient is better served by an alar wedge excision.  This technique leaves a small scar along the junction of the nostril  and the cheek  This excision can be combined with a sill excision to produce a “compound” nasal base reduction.

Width of the nasal base must always be evaluated relative to the rest of the nose. Changes in width made to the the bridge and the tip must be proportional to the base.  Usually, a base reduction is performed at the end of the rhinoplasty procedure, after the upper  two thirds of the nose have been appropriately narrowed or refined.