Alar Base Procedure for Asian Nose?

I'm fine with my nose, save for it's always been too large at the base, and is especially bad when I smile as it flares out.

It's out of proportion with the rest of the nose and makes what looks like a cute pug nose to one that looked like a hand smashed it when I smile. Also, now I've noticed one nostril is off balance with other, I guess due to age. Can the alar procedure alone be done for this?

Doctor Answers 6

Asian rhinoplasty

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An alar base procedure can be performed to narrow the base of the nose, but keep in mind that there will always be some flare when you smile. This is very normal, and occurs in all noses to a greater or lesser extent. You would need to be examined to determine if you would require anything else to achieve your goals with your nose. For example, some Asians require grafts to the dorsum of the nose with reduction of the tip, which reduces the "smashed" appearance. When you see a surgeon, let him or her know your goals and concerns so that these can be addressed. Good luck.

Alar base procedure not good for all Asian noses

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Each rhinoplasty should be individualized for each patient. In almost all cases, the bottom of the nose is too wide if it is wider than the distance between the inside corners of the eyes. In most cases, narrowing a wide tip will improve the balance and harmony of the face. However, the amount the alar bases can be narrowed depends on the configuration of the junction of the nostril rims with the upper lip. If the nostril rim curves inward to meet the lip, the patient is a good candidate. However, if the rim at this location is straight and meets the upper lip at a right angle, it is very difficult to narrow these noses and keep them natural looking.

As far as your nose widening when you smile, this is normal in most noses. the smile muscles travel from the cheek bone and the nostrils. When these muscles contract, they pull the nostril bases toward the cheek making the tip wider. This is made better by projecting the nasal tip forward so there is more tension at this junction of the tip and eyes which resists the natural tendencies for the nostrils to move laterally.

Jack P. Gunter, MD (retired)
Dallas Plastic Surgeon

Alar base reduction

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Alar base reduction is a procedure that yields great results but takes a highly skilled surgeon to perform successfully.  Thank you, and best of luck to you.

Dr. Nassif

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Alar base surgery can help a wide Asian nose

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I have had good success with improving a wide nasal base with alar base surgery. As Dr. Slupchynskyj mentions, there are several methods for accomplishing alar base reduction and these should be discussed during consultation. With an Asian nose I think it is important to asses for nasal tip support since improvement of the nasal base is often best with some tip modification.

Mark Beaty, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Alar base narrowing can be done alone without doing a full rhinoplasty.

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 Most patients noses will get wider when they smile. But when the nose is wide in repose, just the base can be narrowed and usually under local anesthesia.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Ethnic Rhinoplasty

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Hi Din,

There are several methods for alar base reduction. The method that would be best for you, in my opinion, is the intranasal horizontal reduction method.

In this method, the incisions are made between the nasal alae and the center of your nose (columella) thus shortening the distance between your nostrils and your columella.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 285 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.