👃 Correcting 'Dragon Nostrils' with Alar Rim Lowering — By Dr. Young-moon Yoo, VIBE Plastic Surgery

💬 Background of Visit

The patient was a woman in her 40s who had previously undergone tip rhinoplasty.

While the overall shape was not bad, she visited our clinic because her nostrils appeared upturned and retained a ‘dragon nose’ shape, which was a major concern for her.

When viewed from the front, the nostrils were significantly exposed, making her impression appear somewhat harsh, and the transition between the nasal tip and the alar line looked unnatural.

In this case, simply lowering the nasal tip further would not solve the issue, so we planned an ‘alar rim lowering’ procedure.

🩺 'Alar Rim Lowering' Surgical Method — Ear Skin + Cartilage Composite Graft

For this case, we harvested a composite graft consisting of both skin and cartilage from the front of the ear (the cymba concha area).

This area is ideal because the scar is not easily visible after suturing, and the thickness of the tissue is suitable for reinforcing the lower part of the nostril.

The harvested composite graft was transplanted into the lower part of the nostril (alar rim) to fill the deficient soft tissue and naturally extend the alar line downward.

As a result, nostril exposure was reduced, and a natural, curved alar line was achieved when viewed from the front.

✨ Post-Surgical Changes

• Reduced exposure of the nostrils that previously looked upturned like a ‘dragon nose’.
• The nasal tip and alar line now connect naturally, softening the overall impression.
• The results harmonize with the previous tip surgery, creating a stable and refined nasal profile.

Even from the front, the boundaries of the nostrils are smooth, maintaining a natural curve and improving the patient’s look to a ‘soft impression without an artificial feel’.

⚠️ Limitations to Consider for Alar Rim Lowering

While alar rim lowering can yield highly satisfying results, we inform patients of the following limitations in advance:

1. 100% symmetry is impossible.

— Slight differences between the left and right sides may remain due to individual variations in nostril thickness and soft tissue elasticity.

2. The horizontal width may slightly increase, creating a ‘plump’ feel.

— This occurs because volume is added to pull the tissue downward.

3. A fine scar may remain at the ear cartilage harvest site.

— While the incision in the front of the ear (cymba concha) is barely noticeable after healing, a fine line may be visible upon close inspection.

4. When viewed from below, the grafted cartilage may appear slightly bulging or be felt.

— This rarely occurs in individuals with very thin skin.

5. The absorption rate of the grafted tissue varies by individual.

— In some cases, the shape is maintained well for a long time, while in others, partial absorption may occur.

💬 Comment from Dr. Young-moon Yoo

• Alar rim lowering is not just about pulling the nostrils down.
• It is a process of balancing the harmony between the nasal tip, alar line, and nasolabial angle. It is especially effective for those who have had previous nose surgery and are concerned about a ‘dragon nose’ or upturned nostrils.
• By securing both structural support and soft curves through an ear composite graft, we can create a natural nostril shape that harmonizes with the line of the nasal tip.

VIBE Plastic Surgery pursues the most natural and harmonious results by precisely analyzing each patient’s face shape, skin thickness, and cartilage structure.

Consultations and surgeries should be performed by a board-certified plastic surgeon!

VIBE that comes from rich experience.

Dr. Young-moon Yoo, Representative Director of VIBE Plastic Surgery

VIBE Plastic Surgery complies with medical laws. These before-and-after photos were taken under the same conditions with the patient’s consent. Complications and side effects such as bleeding, inflammation, infection, and asymmetry may occur depending on the individual, and caution is required.