Is it possible to thin the alar margin through a rhinoplasty? If so, by how much? (Photos)

Question

Red shows alar base reduction, blue is alar margin/ rim slimming (sailor excision, subcutaneous defatting?), green is shaved parts of tip, purple is added tip structure. Thanks a ton! I’m generally th emlat concerned about the alar margin slimming since I have only seen it done 1-2 times and therefore have no idea to what extent it can be slimmed (my nose also has a slight curvature making my alar margin seem 1-2mm thicker than it is)

Edwin Kwon, MD, FACS · Answer

Yes, the alar margin can be thinned during rhinoplasty, but it's one of the areas where I'm the most conservative. The rim is a thin strip of skin and soft tissue with very little structural support, and over-thinning it can lead to notching, retraction, or a pinched nostril shape that is very difficult to correct later. When it's appropriate, a small amount of soft tissue can be carefully removed from the inner side of the rim, and the realistic change is usually modest rather than dramatic. Your skin thickness plays a big role here, since thicker skin limits how much definition shows through no matter how much tissue is removed. You also mentioned a slight curvature, and that matters—straightening the nose and refining the tip can make the rims look thinner on their own, so the rim itself may need less work than you expect. Rim thinning, Alar Base Reduction, and tip shaping all affect one another, so they need to be planned together to keep your nostrils balanced, open, and natural. I'd encourage you to schedule a consultation so your rims can be examined in person and a safe amount of refinement can be determined for your nose.

C. Carson Huynh, MD, DMD, FACS · Answer

Hello. The alar margin can be thinned only a little. Sailor excision and defatting are limited by the remaining skin and the blood supply of the rim. I typically expect a modest change, on the order of a millimeter, not a dramatic slimming, and a curved alar margin can look thicker than it is. Alar base reduction, rim work, and tip structure have to be planned together or the nostril will look pinched.

Donald B. Yoo, MD, FACS · Answer

Subcutaneous fat can be removed from the skin envelope, excess flare and volume of the ala reduced, and the overall width of the ala narrowed during Asian rhinoplasty with alarplasty.

Is it possible to thin the alar margin through a rhinoplasty? If so, by how much? (Photos)

Answers (3)

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