Can an Alar Reduction Compromise Breathing?

The short answer is very unlikely. Your nostrils are not the narrow part of your respiratory tract. That part is about an inch back from the nostril opening and is called 'the nasal valve'. Therefore the base of your nose can be narrowed, usually as much as needed without compromising your breathing. If the narrowing is excessive, then you would expect not only trouble breathing but an abnormal appearance.

Alar reduction typically refers to excisions of the nasal sill or nostril excisions to reduce nasal tip width.  This usually does not result in breathing difficulties since the external nasal valve is not compromised by this procedure.

Anything is possible but a correctly performed alar base reduction will doubtful give you any airway difficulty.

Alar base reduction will have no effect on breathing when properly done. Therefore, see an experienced rhinoplasty surgeon.

When performed judiciously, alar base modification should have no effect on breathing.  Typically the sensation of nasal obstruction or flow is most easily affected at an area referred to as the "nasal valve", which should not be affected by alar base modification.  Another way to explain this is that since the inlet of the nostrils - where the alar base modification occurs - is not the bottleneck to airflow, judicious narrowing of it will not compromise breathing.  

Alar reduction, if performed in a conservative fashion, will not create a breathing problem.  It is also important to make sure that there is no underlying preexisting abnormality such as a deviated septum or valve collapse that are already restricting the airflow through the nose.

It is doubtful that an alar base reduction would cause airway difficulty unless the lumen was significantly compromised.

Great question! As we reduce ala flare and diameter will we compromise breathing? Physics say 'yes' as flow is increased (or decreased) by the fourth power of the radius. In practice however, the nostril opening diameter may not the limiting factor, the support of the ala is. If the ala is soft and prone to collapse flow is restricted. With good support, the airway will be just fine.

No responsible surgeon can answer this question without knowing more information about you and examining your nose first. 

 

Whether alar base reduction can affect breathing has to do with:

1) Starting width and circumference of your nostrils

2) How much reduction is necessary

3) Whether its an alar flare reduction or an alar sil reduction or both

4) Whether the surgeon's incision is going to penetrate the vestibule of your nose and make the actual hole smaller too

5) whether you have nasal airway obstruction to start with as well as the condition of the septum and turbinates which could also be adding areas of obstruction to airflow

 

If the nostril hole is going to get smaller then its purely physics and math: a smaller hoe will provide greater obstruction to airflow.  Simple as that.

 

With that said, I have never had a patient subjectively complain of nasal airway obstruction after nostril reduction but im sure objectively there would be less airflow.

 

The narrowest part of the nasal airway is called the "internal nasal valve" and its located just inside the nose.  Any changes to the size of the airway at this location has the greatest impact on the efficiency of the nasal airway.  The nostrils themselves are not at this critical "bottleneck" and are less likely to cause congestion if altered.  Typically, nostril size can be reduced very effectively without causing obstruction. That being said, however, any experienced rhinoplasty surgeon that makes nostrils smaller with alar base reduction must still be careful so as not to contribute a sense of congestion to their rhinoplasty patient, and to close the incisions meticulously so as to keep the scarring invisible.  I would not recommend having alar base reduction with an inexperienced rhinoplasty surgeon.