I was advise to perform an open procedure to breakdown my nasal structure and straighten it, a septoplasty to relieve breathing difficulty. I also requested to reduce my alar-flaring due to my big nostrils and smaller the width. To reduce my nose and sharpen it. Some doctors said they could do all 3 procedure in one session, However some could not perform alar-plasty while doing an open. I am an Asia male with an injured crooked nose for 5-6years ago. I have a very thick skin on my nose.
Can Alar-plasty Done Together with Open Rhino & Septo?
Doctor Answers 8
Alar base modification, alarplasty, during open rhinoplasty
As long as your medical history and comorbidities (smoking) do not put you at increased risk of vascular compromise (poor bloodflow), then alar base modification can be safely performed along with open rhinoplasty and septoplasty during the same operation. Those three procedures are commonly combined for Asian rhinoplasty because they address the form and function of the nose, and help to restore the balance of the bridge (dorsum), tip, and nostrils.
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Alar base excisions and open (external) rhinoplasty
Typically these procedures can be done simultaneously. The septoplasty portion of the procedure should have no bearing on the blood supply to the nasal tip. Furthermore, the 'open' or external approach can be done in conjunction with typical alar base excisions. Some cause for concern would be in cases of revision, or very aggressive alar base excisions, whereby the incisions extend up onto the face/nose junction (alar groove) more superiorly. In these cases, the theoretical risk rises. However, we are very fortunate that the blood supply to the face/nose is so robust that it is not an issue. While individual case reports of problems with these may exist, in general these are very safe to perform together.
Alarplasty with Open Septorhinoplasty
I've done an alarplasty as part of a septorhinoplasty many times, but each procedure is individualized. From your description it sounds like it would be appropriate in your case. If you send pictures I could confirm my impression.
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Alarplasty can be done with rhinoplasty and septoplasty
We perform rhinoplasties with closed techniques and do alarplasties at the same time when necessary. The septum can also be repaired at the same time as well. The septoplasty procedure is typically billed to the patient’s insurance out of medical necessity while the cosmetic surgery is paid for by the patient. All of these procedures can be done at the same time under one general anesthesia. The thick skin on the nose is best addressed postoperatively with Blenderm tape and cortisone injections in the first 6 months after the procedure.
The components of a rhinoplasty you describe are very common requests from Asian patients and can generally be done at the same time in one surgery. Please consult with a board certified specialist who can best assist you in achieving the results you seek.
Nostril Narrowing with Open Septorhinoplasty
While the vast majority of nostril narrowings are done at the same time as an open septorhinoplasty, there may be some hesitation depending upon the type of nostril narrowing being done. Nostril narrowing that includes rim resection and wrap around the nostrils up to the alar crease may have some blood flow concerns for the blood supply to the nasal tip skin. It would be helpful to know what type of nostril narrowing procedure is being considered. It is always hard to argue with safety, however, when one is concerned about survival of your nasal tip skin. But internal wedge sill resections are never a problem with an open rhinoplasty.
Open Septorhinoplasty with Alar Reduction is done together
I do the majority of my Septorhinoplasty procedures open and whenever an alar reduction is necessary this is done at the same time. A septorhinoplasty is basically the "Septo" portion being the functional aspects of the procedure and the "rhinoplasty" portion is the aesthetic portion of the procedure. If the alarplasty is necessary which is quite common in asian rhinoplasty then there should be no reason not to do all three procedures in conjunction. Best regards!