A short, spread upturned nose — can it improve without alar reduction? — tip cartilage grafting and the nasolabial angle
2024. 12. 24.
When a short, spread upturned nose comes with bulbous-nose worries too — organized cases where improvement is reviewed through tip cartilage grafting, the columella-ala relationship (ACR), and nasolabial angle adjustment without alar reduction.
Key points
- For a short, spread upturned nose, if the cause is tip·columella structure rather than the alae's own width, improvement can be reviewed without alar reduction.
- When the columella-ala relationship (ACR) and the nasolabial angle between nose and upper lip are adjusted together, frontal nostril exposure can change.
- If alar reduction is needed, performing it is fine — but excluding unnecessary incisions when not strictly needed is the principle.
"I have a short, spread upturned nose so my nostril alae and tip look wide. Can it improve without alar reduction?"
I'm Director Hyung-taek Kim of KOWON Plastic Surgery, which values nose balance. This is a question often asked by people whose upturned nose shows nostrils frontally and who also worry about a sideways-spread bulbous nose. Many wonder whether alar reduction is mandatory in such cases — I've organized the criteria for judging, based on actual cases.
01
Can alar spread improve without alar reduction?
If tip·columella structure is the main cause, tip cartilage grafting and position adjustment alone can change the spread-looking impression. However, if the alae's own width is wide, separate reduction may be needed.
If the reason the alae look spread is entangled with tip height·direction rather than the alae themselves, the impression can change with tip adjustment alone — no alar reduction.
On top of that, when columella position is adjusted and the columella-ala relationship (ACR) and the nasolabial angle between nose and upper lip are viewed together, frontal nostril exposure can change. ACR and nasolabial angle are different criteria so they aren't used as the same term.
02
By which method is the nasolabial angle adjusted?
For nasolabial angle (the angle the nose and upper lip form) adjustment, J-curl surgery is used — bringing the tip and columella forward.
| Check item | Content |
|---|---|
| What is done | Bring the tip and columella forward to adjust the nasolabial angle |
| Frontal change | Nostril-exposure change possible — range differs by structure |
| Profile change | The mouth can look relatively less protruded |
| Alar reduction·ala excision | Bulbous-nose improvement possible without it |
When tip and columella position are adjusted and the nasolabial angle changes, the mouth can look relatively less protruded. However, whether this change can replace alar reduction requires checking the alae's own width and tip structure. What kind of procedure J-curl surgery is can be seen in more detail in the J-curl procedure guide.
03
Then when is alar reduction done?
Of course when alar reduction surgery is needed, performing it is fine too. This doesn't mean alar reduction is unconditionally unnecessary — it means when improvement comes from tip-side adjustment alone, there's no need to add more.
Many people worry about the incision scar and added cost burden of alar reduction. So the principle is excluding unnecessary surgery except when strictly needed. Whether the state needs alar reduction or tip cartilage grafting and nasolabial adjustment suffice is judged after checking the nose's state directly.
04
Summary — the tip is read before the alae
Even when bulbous-nose worry overlaps a short, spread upturned nose, alar reduction isn't decided first. Evaluating tip cartilage, the columella-ala relationship, and the nasolabial angle together distinguishes whether the desired change is possible with tip correction alone or whether separate alar incision is needed. Which case your nose falls under can be confirmed by getting diagnosed in a 1:1 consultation. Actual improvement cases can be seen in before-and-after photos.
Frequently asked questions
Answers to common questions patients ask before a consultation.
If an upturned nose and bulbous nose coexist, is alar reduction mandatory?
What's good about surgery without alar reduction?
If the nasolabial angle is adjusted, do parts other than the nose change too?
Responses to treatment and recovery progress vary by individual. Outcomes and side effects vary from person to person. Bleeding, infection, swelling and asymmetry may occur. Please consult our medical team before making a decision.