Masataka Fujihashi
2026.01.24
What is the rhinoplasty? | Explaining the causes of prominent nostrils and how to improve them
As a plastic surgeon certified by the Japanese Society of Plastic and Reconstructive Surgery, I have been involved in many cases of trauma, reconstruction, and congenital diseases, and have cultivated precise techniques and a deep understanding of anatomy. He entered the field of cosmetic surgery out of a desire to bring the power of cosmetics to his patients, as a change in one's appearance can also make one's mind more positive. Her specialties include general treatment of the eye area, injections, and sagging skin. I provide treatments that focus on beauty with the medical stance of "sincerely addressing the ideals of the patient.
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Designing natural beauty with trust.
I am Masataka Fujihashi, a board-certified plastic surgeon.
A surprisingly common concern among rhinoplasty consultations is that the nostrils stand out when viewed from the front. Even if the bridge of the nose and the tip of the nose are adjusted, if the impression of the nostrils is strong, there will remain some imbalance.
An effective procedure in such cases is the "nasal rim descent" surgery.
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Purpose of Nasal Rim Descent
The nostril rim descent is a frontal view of theSurgery to make the nostrils less noticeableis.
The nostril rim is the rim of the nostrilsand by lowering this position, the nostrils are more easily hidden from the front or oblique front view, giving a more natural impression of the nose.
It is also useful when there is a left-right difference and the nostrils are easily visible on only one side.
Nasal rim descent may be performed alone or at the same time as so-called "full nose" surgery, such as apex plication or nasal septum lengthening.
In the overall design of the nose, the position of the nostril rim is also adjusted together to achieve a more balanced result.
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Main causes of prominent nostrils
There are three main causes of prominent nostrils.
(1) If the nose extends laterally
If the nose is large, the nostrils are also elongated, emphasizing the width and roundness of the nose.
(2) When the tip of the nose is pointing upward
The so-called up nose makes the nostrils more visible from the front.
Mild cases can be handled with nostril margin descent alone, but depending on the shape, nasal septum extension may be used in combination with nasal septal extension.
(iii) When the nostril margin itself protrudes obliquely or upward
It is similar to upnose, but structurally it is a different problem and has a different approach.
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■ Recommended for those who:
Those whose nostrils appear domed from the front
Those who are concerned about the left-right difference in nostrils
For those who want to reshape the nose after nasal wing reduction.
Those who want to make large nostrils look smaller.
and others are applicable.
Especially for those who say, "The bridge of the nose and the tip of the nose are not bad, but for some reason only the nostrils are bothering me," nostril rim descent is often suitable.
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Practice of the treatment
The surgery is performed through an incision on the inside of the nose, which is then peeled back under the skin and the nostril margin is pulled down.
Because there is not enough skin as it is,Skin graft with cartilage taken from the earThe most common method is to do so.
Since skin grafts alone are prone to retroversion, the inclusion of cartilage provides internal support and stabilizes the position.
On the other hand, if the procedure is performed at the same time as so-called "full nose" surgery, such as apex formation or nasal septum lengthening, the surgeon may choose to insert only cartilage instead of skin with cartilage.
In this case, the changes are milder, but it is possible to line the nostril rims at the same time as the nasal full.
After surgery, gauze is fixed inside and outside of the nose to promote the growth of the transplanted tissue, and pressure is applied for approximately one week.
Rest during this period will greatly affect the outcome.
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Downtime/risk
Swelling, internal bleeding, and pain are comparable to general nasal surgery.
Ear wounds will be red for several weeks, but will gradually settle.
There is no risk of protrusion of grafted tissue, exposure of nasal hair, left-right difference, retroversion, or skin necrosis.
Postoperative management is very important, especially since strong pressure during the growth period increases the risk of necrosis.
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■ Summary
Nasal rim descent is an effective procedure for the delicate problem of prominent nostrils.
It may be performed on the nostril rim alone or in combination with surgery on the entire nose, with the choice of skin graft with cartilage or cartilage only, depending on the case.
It is important to properly evaluate the structure of the nostril margin descent, as it can be a difficult procedure to perform if the indications are misjudged.
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【Profile】
Masataka Fujihashi, MD, Plastic Surgeon
Leveraging expertise as a board-certified plastic surgeon, I offer comprehensive facial cosmetic procedures including eyelid and nose surgery, facial liposuction, thread lifts, and hyaluronic acid injections. From incisional surgeries and revision procedures requiring delicate design to minimally invasive injections and lifts with minimal downtime, I strive to provide treatments tailored to each patient's ideal outcome.
We are dedicated to achieving natural results and minimizing downtime, pursuing medical care that leaves you feeling confident in your choice through sincere consultations.
Designing natural beauty with trust.
We cherish that sentiment and apply it to our daily practice.
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【Career】
March 2015: Graduated from the School of Medicine, Showa University
April 2015 Showa University Yokohama Northern Hospital Initial Clinical Training
April 2017 Showa University Hospital Department of Plastic Surgery
October 2017 Maebashi Red Cross Hospital Plastic Surgery / Cosmetic Surgery
April 2019 Nishio Municipal Hospital Plastic Surgery Department
April 2020 Showa University Fujigaoka Hospital Plastic Surgery Department
November 2020 Ota Nishinouchi Hospital Plastic Surgery / Cosmetic Surgery
July 2022 Tokyo Rosai Hospital Plastic Surgery / Cosmetic Surgery Department Head
July 2022: R.O.clinic (Part-time), Kusano Taro Clinic (Part-time)
April 2024 Deputy Director, Ginza TA Clinic
November 2025 BIANCA CLINIC
【Professional Affiliations and Qualifications】
Japanese Society of Plastic and Reconstructive Surgery Board-Certified Plastic Surgeon
Member of the Japanese Society of Aesthetic Plastic Surgery (JSAPS)
Member of the Japanese Society of Aesthetic Surgery (JSAS)
