Patients have many concerns when they are seeking cosmetic improvements for their nose. Some patients feel like they lack a nose bridge projection (and maybe due to genetic factors) and wish to augment their bridge. Some patients have a “hump” on the bridge of the nose and wish to minimize that hump. A very common concern patients have regarding their nose is that their nostrils (Ala) are too wide. A “normal” alar base width is typically the same width as the intercanthal space (between inner corner of eyes). See diagram A. If the alar width is wider than this distance, patients may perceive that their nose or nostrils are too wide. The alar width can also expand during smiling due to the muscles in the ala that cause them to flare. The flaring is commonly treated with neurotoxins such as Botox or Dysport which relax the muscles.

Diagram A

A common procedure that does involve going under the knife or getting surgery called  is Alar base reduction whereby a surgeon makes an incision and sews the alar back in a more narrow position. Sometimes small segments of the nostril are removed to reduce the overall size and shape of the nostril.

Now a nonsurgical option is possible to narrow the Ala width. Dr. TJ Tsay has developed technique called CAT WHISKER TM using absorbable PDO threads to literally pull the outer edges of the  ala to a more narrow position. The procedure involves precisely guiding a barbed thread underneath the base of the nose.  After the guide is removed there are short thread segments protruding from the sides of the nostrils. These short segments (which resemble a “Cat Whisker”) are then buried underneath the upper lip area in a cris cross fashion to hide any visible threads.  Smooth PDO threads are then inserted in the nostrils to further tighten the ala. Finally neurotoxins are injected into the ala to relax and atrophy the muscles  of the nostrils.

This procedure is NOT claiming to substitute for the Ala base reduction surgery as it does have its limitations. First of all the results are NOT permanent. The PDO threads dissolve after 6-8 months but the effects usually last longer than that. Individual results may vary.

Can I get the Cat Whisker TM if I have had previous fillers?

Yes.  You can also get fillers after getting Cat Whisker if you wish to augment the nose bridge or nose  tip.

Can I get Cat Whisker TM if I have had previous rhinoplasty?

Most of the time you are able to get Cat Whisker even if you have had prior rhinoplasty.   However you should consult with Dr. Tsay to make sure this is a possibility.

Is there downtime after this procedure?

There is moderate to severe swelling for 1-2 weeks after this procedure. Most patients are able to return to work after 1-2 days but may be required to wear a gauze dressing over their nose for a few days.

Does the procedure have any effect on breathing?

Initially there may be some swelling and congestion immediately post procedure but this resolves once the swelling has subsided.Some patients even report improved breathing after the procedure.

Are there any side effects from this procedure?

As with any procedure that involves injections, post procedure discomfort or pain, swelling and bruising are expected. Not so common side effects may be infection, asymmetry (most patients have existing nose and face asymmetry), thread migration or thread extrusion, nosebleeding (transient).

Does the CAT WHISKER TM procedure slim the tip of the nose if one has a “bulbous nose tip?”

Although this procedure does slim the nostril, it does NOT slim the tip of the nose. We have another nonsurgical procedure that can slim down the bulbous tip of the nose by injecting kenalog into the side of the nose tip where there is excess “tissue.” Please inquire about our kenalog injections if wanting to slim the tip of the nose or even combine it with the CAT WHISKER TM procedure.