Nose Wing Reduction

Nasal wing reduction is a minor surgical procedure that involves removing a portion of skin and soft tissue at the base of the nostrils or the floor of the nose, followed by suturing to create a slimmer nasal wing and smaller, more symmetrical nostrils. The incision is made close to the nasolabial fold or inside the nasal floor, allowing it to fade over time. This procedure is indicated for cases of truly flared nostrils and is often performed in conjunction with rhinoplasty.

Medically reviewed by BS.Ths.CKII Nguyễn Xuân Vũ — BonBoz Clinic

Mechanism

Flared nostrils are caused by thick soft tissue, wide alar base, or large nostrils. The reduction technique involves excising a wedge-shaped piece of skin at the alar base (Weir), at the nasal floor (narrowing the base of the nose), or a combination of both, depending on the excess: if the outer wing is flared, excision is done at the alar base; if the nostrils are too wide, the floor is narrowed; if both issues are present, a combination approach is used. After suturing, the alar base is pulled inward and the nostrils are reduced in size.

When is it necessary and when is it not?

It is necessary when the width of the nostrils exceeds the distance between the inner corners of the eyes after considering a potential lift of the nasal tip, or when the nostrils are too wide and the alar base is thick. It is not necessary when the flaring is relatively minor due to a low nasal tip — lifting and elongating the tip will pull the wings inward. The doctor will simulate the results beforehand so you can see where the improvements will come from, avoiding unnecessary excision of the alar wings.

Why is 'just enough excision' the principle?

Once the tissue of the nostrils is cut, it cannot be restored. Excessive cutting can lead to distorted nostrils, notching of the alar wings, asymmetry, and sometimes narrowing of the nostrils affecting breathing — revisions are very difficult and may require tissue grafting. Therefore, the doctor measures both sides with a ruler and standardized photos, cuts slightly below the expected amount, and adjusts during suturing.

Risks to be aware of

Scarring at the alar-cheek crease (pink for 1-3 months, thicker skin takes longer to fade), uneven nostrils, distortion or notching of the alar wings if cut excessively, narrowing of the nostrils, temporary numbness of the alar base, and infection (rare). Thick skin may improve more slowly than thin skin.

At BonBoz

The plastic surgeon measures the nose-to-face ratio, identifies the excess (alar base, nasal floor, or both), and typically performs this procedure in conjunction with a rhinoplasty to achieve overall balance between the bridge, tip, and wings. The examining doctor is the one performing the surgery, clearly explaining the incision location and length, the expected reduction level, and the principle of just enough excision.

How is it performed?

Local anesthesia is administered, either during the same rhinoplasty procedure or separately. The doctor marks a wedge-shaped area on the skin at the alar base and/or the nasal floor, based on measurements taken from both sides. The tissue is then incised and removed, and the alar base is pulled inward. The doctor sutures the area in multiple layers with fine thread, ensuring symmetry on both sides throughout the suturing and adjustment process. The procedure typically lasts 30–45 minutes for both sides if performed separately.

Before the procedure

Measure the width of the nostrils and the distance between the inner corners of the eyes, take standardized photos, and create a simulation; discontinue anticoagulants, alcohol, and smoking as instructed; combine with the rhinoplasty plan if applicable.

After the procedure

Keep the area dry and clean. Mild swelling may occur for 5–7 days, and sutures will be removed on day 7. Expect pink scars for 1–3 months, and use sun protection and scar gel. The shape will stabilize in 3–6 months. Follow-up appointments are scheduled for day 7, month 1, and month 3.

Possible risks — your doctor explains them before treatment

Nasal-Malar Fold Scarring
Asymmetrical Nostrils
Deformity or Notching of the Alar Base if Over-Resected
Narrowing of the Nostril
Temporary Numbness of the Alar Base
Infection (Rare)

Who should NOT have this?

The nostrils are relatively wide due to a low nasal tip (a nose lift is adequate).
The nostrils are naturally small or breathing is already compromised.
The wings have been previously reduced and there is minimal tissue remaining.
There is a clear tendency for hypertrophic scarring.
There are expectations for very small nostrils, irrespective of skin thickness.

BS.Ths.CKII Nguyễn Xuân Vũ

Department of Plastic and Aesthetic Surgery

Master of Medicine and Pharmacy — Specialist Level I Surgical Resident, Hue University of Medicine and Pharmacy (2014–2017)
Specialist Level II Doctor in Plastic and Aesthetic Surgery
Specialist Level I in Plastic and Aesthetic Surgery — Pham Ngoc Thach University of Medicine; Specialist Level II in Healthcare Management — University of Public Health
Specialty Certificate in Orthopedics and Traumatology and Certificate in Plastic and Aesthetic Surgery (2017)
Medical Practice License No.: 007827/ĐL-CCHN — Issued by Dak Lak Province Department of Health on 04/12/2017
Over 15 years of experience, more than 20,000 surgeries
Specialist Level II Doctor in Plastic and Aesthetic Surgery at Ho Chi Minh City Hospital of Dermatology (2020–present); previously Lead surgeon for major and minor procedures at Sao Han Hospital (2018–2020)
Member of international humanitarian organizations Operation Smile and ReSurge International — performing pro bono reconstructive surgeries for patients with congenital deformities, cleft lip, cleft palate, and ptosis (2022–present)
Affiliated with Alcon Pharmaceutical (USA)
Member of the Korean College of Cosmetic Surgery (KCCS)
Medical Director of BonBoz Clinic

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Frequently asked questions

Will nostril reduction leave scars?

There will be a scar at the crease between the nostril and cheek or inside the nasal floor, which will be pink for 1–3 months and gradually fade over 6–12 months; thicker skin may take longer to fade.

Can it be done together with rhinoplasty?

It is usually recommended to do both at the same time so the doctor can balance the bridge, tip, and nostrils in one session; it can also be done separately once the other parts have stabilized.

Does nostril reduction affect breathing?

A proper amount of tissue removal does not affect breathing; excessive removal can narrow the nostrils and weaken the external nasal valve. This is why doctors adhere to the principle of minimal cutting.

How long does swelling last?

Mild swelling lasts for 5–7 days, with stitches removed on day 7; the shape of the nostrils stabilizes within 3 to 6 months.

If the nostrils are uneven after the procedure, can they be corrected?

It can be adjusted, but it is more challenging since tissue has been removed; making an accurate initial cut and careful measurement is the most important.

Can thick skin on the nostrils be treated?

Yes; thicker skin may improve more slowly, and the doctor may remove additional subcutaneous tissue. The expectation is for a gradual reduction in size.

Is there an injection that can make the nostrils smaller?

There are no safe and lasting injectable substances that can effectively reduce nostril size.

What is the cost of nostril reduction?

It is lower than rhinoplasty; when done together with rhinoplasty, the doctor will provide a comprehensive package after the consultation.