Alar Base Reduction with Local Anesthesia After Actual Revision Rhinoplasty

are there any risks involved with this procedure? My breathing is not perfect. Is there a risk that my breathing be impaired? Are the stitches usually visible afterwards? I have been advised that for safer results it could be performed with local anesthesia after actual operation. Is it an easy procedure?

Doctor Answers 12

Alar Base Reduction with Local Anesthesia After Actual Revision Rhinoplasty

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Alar base reduction brings to nostrils and the base of the nose closer together.  It will require incisions just inside the nsotrils and use of a permanent bunching suture.  It can be performed under a local anesthetic but not certain why you wouldn't have it done during your Rhinoplasty.

Alar base reduction, like all Rhinoplasty techniques, relies upon the proper aesthetic judgment following the nproper aesthetiocs of faclal beauty.  

Alar Base Reduction

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As stated, alar base reduction is used to reduce the base width of the nose (looking straight on and the width at it's lowest point). This can be done in different ways to include or not include the nostril. Obviously if the nostril is included in the reduction, the opening for airflow will be reduced. If your nostril was small to begin with, an experienced surgeon would not disturb this in the reduction. Problems with breathing after this type of procedure would be rare if this rule is followed. It is not a difficult procedure and the scars are not that visible. Having it done under loocal anesthesia is possible but I would forewarn you that this area of the nose is very sensitive and the initial placement of the local anesthetic could be a bit uncomfortable.

Alar Base Reduction after Revision Rhinoplasty

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There are some risks with every procedure, but compromising nasal breathing is very unlikely with alar base reduction. This surgery can be done under local anesthesia. Stitches will be seen until they are removed 5-6 days after surgery, .

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Revision rhinoplasty for me?

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Yes, there are risks (associated with any and all procedures). Unlikely that breathing will be impaired. Stitches usually not visible after removal. No procedure is easy, or else it wouldn't take so many years to become a board certified plastic surgeon.

Alar base reduction under local anesthesia is appropriate, but not to "correct" breathing problems!

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Alar base reductions (Weir excisions) are performed to reduce the size of the nostrils, reduce the width of the base of the nose, or make other changes in the appearance of the sides of the nose base where the nasal alae meet the cheek and upper lip. This can be performed as part of a rhinoplasty while anesthetized, or separately under local anesthesia, since these areas are away from the rest of the rhinoplasty procedural steps.

What you should understand is that alar base reductions are done for appearance changes, and since tissue is removed, never improves breathing. In fact, if too much is removed, the nostrils can be made overly small and this could restrict breathing! But in most cases, it neither improves nor reduces breathing; that generally occurs with septal or turbinate changes.

Yes, you will have stitches, but these are removed by 4-7 days after surgery, and the scars are usually well-concealed in the normal crease between your nose and cheek. They fade quite nicely over time and are usually scarcely perceptible. I don't know about "safer," but if you or your surgeon are not sure about doing this step or not, waiting to see the results of the revision rhinoplasty (and assessing your breathing issues) is certainly a reasonable plan! Discuss with your surgeon. Best wishes!

Timing Of Alar Base/Nostril Narrowing

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Alar base or nostril narrowing involves the removal of a wedge of skin that will result in a fine line scar inside the nostril. It is almost never a scar concern although every skin excision leaves a scar. Whether it is done as part of any rhinoplasty or done later as a stand aloine procedure in the office depends on the certainty that it would be aesthetically beneficial. It is not a procedure that is known to adversely affect nasal breathing.

Alar base reduction

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Alar base reduction can be an effective method of cosmetic improvement of the nose but must be balanced carefully against possibled adverse breathing and cosmetice consequences.  I often recommend making this decisionseveral months following the initial or revision rhinoplasty when the nose can be reassessed and these incisions avoided if possible.  If alar base reduction is determined to be appropriate, this procedure can generally be performed under local anesthesia. 

Alar base reduction under local anesthesia

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Morning, I think that's absolutely fine.  Regarding your breathing, potentially there is a risk your breathing could be very slightly impaired, but it's unlikely.  Doing the reduction after the revision rhino has couple of advantages.  One, you get to see what your breathing is like after your rhino and then decide whether you want to proceed with the base reduction.  Two, you get to see what the nose looks like and then decide whether you want to proceed for cosmetic reasons.  I think it's fine.  In any case, if you can wait, give yourself several weeks to see what the nose looks and functions like before  you go ahead with it.


Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 76 reviews

Alar base reduction and anesthesia

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Alar base reduction can certainly be performed under local but it really depends upon the tolerance of the patient.

Alar Base Reduction with Local Anesthesia

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I think you are putting the cart before the horse. Reducing a flaring nose base will NOT improve breathing. I am therefore not sure why if your breathing "is still not perfect" after a REVISION rhinoplasty, why shouldn't your surgeon be focused on correcting the breathing? After all, a less flaring nose whose breathing is still blocked makes little sense.

A nasal flare correction can be done under local anesthesia.

Peter A. Aldea, MD
Memphis Plastic Surgeon

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.