Okay to Have Alarplasty a Year After Rhinoplasty?

I want to get Rhinoplasty to fix my bulbous tip, but I am not sure if I need alarplasty as well. If I decide to get Rhinoplasty, can I get alarplasty a year later? Would this be considered a revision rhinoplasty to fix existing rhinoplasty?

Doctor Answers 11

Acceptable to have alarplasty one year after rhinoplasty

Yes, indeed it is acceptable to have an alarplasty the year after the previous rhinoplasty surgery. Alarplasty can be usually done under a local anesthetic and does not need full general anesthesia.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Alarplasty after Rhinoplasty

The alarplasty is usually performed at the same time as the original rhinoplasty, but occasionally patient and surgeon prefer to stage the two procedures. I see no advantage to having two operations. Whether or not you call this a revision is just a matter of semantics.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews



This would not be considered a revision, it is narrowing the ala (with weir incisions). It may be performed at the same time or at different times. Hope this helps answer your question.

Dr. Nassif

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 47 reviews

Alarplasty and rhinoplasty

 It is perfectly reasonable to wait to have an alarplasty after a rhinoplasty.  Waiting one year is a good idea to allow for tissue swelling to diminish.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews


Yes it's OK to wait a year to get an alarplasty. You can even do the alarplasty 2 months after the initial procedure. This would not be considered a revision rhinoplasty.
You should also consider computer imaging of your nose so you can see what your nose will look like after the surgery. This should give you a good idea of the alarplasty before you decide to get it.
Dr. S.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 274 reviews

Alarplasty can be done at separate time as rhinoplasty

Nostril reduction surgery (called Alarplasty / Alar Base Reduction) is a procedure that can narrow the width of the nostril base, decrease the amount of nostril flaring, or decrease the size of the nostrils.

To accomplish this, the surgeon makes an incision in the crease where the nostril wall meets the cheek. A wedge shaped piece of nostril wall is removed, and when the incision is sewn closed, the nostril narrowing is achieved.

Alar base reduction is typically performed as the very last step in rhinoplasty. After all of the changes are made to the nose, your surgeon should then analyze the nostril width and flare. If these factors need to be improved, then the surgeon usually proceeds with an alarplasty.

It is possible to perform this procedure alone or as part of a rhinoplasty. It can be performed alone, but keep in mind that in order for the nose to appear natural, it must adhere to certain proportions and also be in balance with the other facial features. To get a better understanding of how your nose might look after surgery, your surgeon should be able to show you computer images that will simulate the proposed results of surgery. Recently, 3D imaging has become available and allows patients to visualize the changes from multiple angle.s

C. Spencer Cochran, MD
Dallas Facial Plastic Surgeon
4.7 out of 5 stars 147 reviews

Rhinoplasty and Possible Delayed Alarplasty

Hi CC,

It is best to give the "green light" to your rhinoplasty surgeon at the time of your initial rhinoplasty to go ahead with alarplasty if felt needed at the end of your operation.

It is perfectly okay to wait and see if it is necessary. The alarplasty can be done under local anesthetic in the office if need be.

Good luck, and enjoy your new nose.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Yes it is.

Though most patients have it done at the same time, some patients with only a small amount of alar width may prefer to do it in a year. There is no problem with doing it that way. The cost will probably be a little more since they will require 2 operations instead of one. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Talk to an expert

Speak to an expert in doing rhinoplasties --- you can have the two done at different times but let an expert assess your problem and give you their opinion. If there is a question of the alarplasty - it can be done once most of the swelling is down. I prefer to do it at the same time as the rhino - but it can be done any time.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

Alarplasty a year after Rhinoplasty is okay

Yes. It is.

Dr. Harold Gillies, the founder of Modern Plastic surgery, had many famous sayings among them was "Never do today what you can honorably put off until tomorrow" . In other words, if circumstances and the patient allow you, you will get better and safer results by breaking procedures into stages.

A bulbous tip that is NOT overly high / sticking out / projecting may not need lowering (to the plane of the face) and correction of the thick arches of the lower lateral cartilages will do the job. IF it needs to me lowered, the nostrils will flare and MAY benefit from an alaraplasty OR NOT.

The benefit of waiting is two fold. First, as the swelling decreaes and scarring matures the extent of flaring becomes clear making the procedure more accurate. second, the blood supply to the tip could be compromised with an alarplasty. Allowing time to pass ALSO all owes for the blood supply to the tip to re-establish making potential tip devascularization less likely.

Good luck - postpone away!

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 109 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.