Revision Rhinoplasty Q&A
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Alar Base Is Wide and Thick after Primary Surgery. Is a Suture Cinch Method The Right Call?
asked 3 months ago by MHappy
Latest answer by William Portuese, MD
Question viewed 192 times
Tags: alar reduction, pinched, sutures, technique
I had nose surgery before, nasal bones were broken. Alar bases looks wide and thick. My doctor wants the suture cinch to narrow the frontal part. Does it going to affect my upper lip or my smile? What are the risks?
5 answers to Alar Base Is Wide and Thick after Primary Surgery. Is a Suture Cinch Method The Right Call?
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Alar Base Is Wide and Thick after Primary Surgery. Is a Suture Cinch Method The Right Call?
Photos, of your nose from the base view and front would be required in order to make the determination if an alar bunching suture would be helpful.
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Cinch technique not recommended for alar base reduction
We do not recommend the cinch technique for alar base reduction due to multiple complications we have seen in our practice. Complications include unnatural bunching of the upper lip area with breakage or infection of the suture itself. A permanent solution is a simple Weir’s alarplasty incision at the base of the inside of the nostrils, which heals quite nicely.
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Use alar cinching suture to narrow nostrils
It's hard to be very specific without seeing your nose. I don't typically use cinching suture techniques when narrowing the nose. Check out my link below for a fuller description of some alar base narrowing techniques.
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A revision rhinoplasty is more difficult, and your desires are challenging.
Hi Mhappy;
With respect to, what I assume is, your desire to have the nostril walls narrowed by suture cinch may or may not be reasonable. Frankly, I think you need some good evidence of how that works before you take it on. It may be good, but each patient is different because the skin may be different, the muscle strength may be different, and be sure to discuss this in great detail. If it works for you, that would be terrific.
You asked about risk. ...
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Alar Base Is Wide and Thick after Primary Surgery
Cinching of the alar will have a minimal effect in the long term and no effect on the width of nasal base. You will need alar repostioning technique, a technique that I developed, whereby, the alae are reduced and repositioned medially. See the before and after photos.
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