Do I have ‘flat wings’ because my nose is wide, or because the cartilage is weak?

“When someone feels their nose is ‘flat’ or ‘wide’ at the base, their focus is almost always on the ‘nose wings‘ (the alae). It’s a very logical conclusion—if it’s wide, we must narrow it.

But here is the truth from a rhinoplasty surgeon‘s perspective: The ‘flatness’ you’re seeing is almost always a symptom of a different problem. In most cases, the real issue is a weak, undefined nasal tip that lacks projection. Before we ever talk about ‘nose wing reduction,’ we have to first talk about building the proper support for your nose.

And as for the ‘natural fixes’ you’ve probably seen, like clips or exercises? Let’s be blunt: they cannot work. This is a structural issue of cartilage and skin. It’s not a muscle you can train.”

Why Your Tip is the Real Issue

Think of your nose as a tent. The nasal tip is the central “tent pole.” Your “nose wings” (the alae) are the canvas walls.

If your central tent pole is short and weak, what happens to the tent? The whole thing looks flat, wide, and splayed out.

This is your nose. Your wings look “flat” and wide because your nasal tip doesn’t have enough height or definition to give them a graceful shape.

The Surgical Plan: We Build Before We Reduce

So, when a patient with “flat wings” comes to see me, my first thought is not “we must cut the wings.”

My first thought is, “We must build a stronger, more defined tip.”

Step 1: The Rhinoplasty (Building the “Tent Pole”) The main part of the surgery is the rhinoplasty itself. I almost always use an “open” approach for this. I need to see your tip cartilages clearly so I can rebuild them.

I will often use tiny, strong grafts of your own cartilage (usually from your septum) to create a “columellar strut.” This acts as a new, powerful “tent pole” that gives your tip the projection and definition it’s been missing.

For many patients, this step alone solves the “flat wing” problem. As we lift and define the tip, the wings are naturally pulled inward, and that flat, wide look just disappears.

Step 2: The Nose Wing Reduction (The Finishing Touch) After the new tip is built and shaped, we then make a final decision.

We look at the new, defined nose and ask: “Are the nostrils still too wide for this new tip?”

If the answer is yes, then and only then do we perform the “nose wing reduction,” or Alarplasty.

This is the precise, artistic step where we remove a small, customized wedge of skin right from the natural crease where your nostril meets your cheek. This brings the wings into final harmony with the new tip.

A Note on Scars

People hear “cut” and they worry about scars. It’s my job as a surgeon to hide that tiny incision perfectly in the natural shadow of your nose. When it heals, it should be a fine line that even you have trouble finding.