Alar Base Reduction Techniques?

I call this alar base correction because there are several excisional techniques that correct this depending on the problem. You mention 2 mm correction but it is also important to consider factors such as the size and shape of the nostrils and the width nostril sill. I will sometimes do both excision and cinch to limit the size of the alar base excision and have found this to be helpful. It is really more important to find a surgeon who has the artistic judgement, surgical skill and the experience to execute the best result. It is not just the width of the base of nose but the effects on the whole nose that are in play here. 

In order to narrrow the alar base of your nose by 2mm on each side, removal of skin and subcutaneous soft tissue would absolutely be necessary. Because of this, a simple suture technique alone is not adequate to accomplish this goal.

The Weir incision technique that you mention is a very specific excision of skin and soft tissue adjacent to the lateral (outside) alar margin.

Alternatively, narrowing of the alar base can be accomplished occasionally by a Wedge excision of soft tissue within the alar base itself. Sometimes, this is a more desirable approach, with less visible scarring.

Fortunately, there are many techniques that produce excellent results with effective narrowing and beautifully hidden scars. The choice of which technique is used must be individualized to your particular condition based on your surgeon's assessment of it, his/her experience with alar base reduction, and your comfort level that you and your selected surgeon fully understand and agree upon the goals and surgical approach.

   Cinching sutures are certainly effective, and they can produce a nice result.  However, the sutures can loosen or break.  I have used them in certain cases, but I primarily rely upon excisional techniques.  Find the plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties each year.  Kenneth Hughes, MD Los Angeles, CA

Hello meow1978, There are a few ways of achieving a reduction in the width of the nostrils. Cinching sutures can be an option but the results may not be as long lasting as you'd like. A weir-type incision usually gives more predictable results.

You can read more about alar base reduction at my web reference link below.

The best way to reduce the ala is by cutting out a wedge of skin where the nostril meets the cheek.  It does take some artistic ability to do them well, but the scars almost always heal invisibly.  

You have to be careful with alarplasty. It is a very difficult procedure. It it goes wrong it can be almost impossible to fix. Instead of focusing on which technique to use you need to focus on finding a surgeon who is REALLY good at alarplasty. Then you explain in detail to the surgeon your desire of how to change the nostrils.

Regards

Dr. J

Disclaimer: This answer is not intended to give a medical opinion and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

There are actually many techniques that can be used to narrow the nostrils.

Depending on alar height, nostril width, overall width and the proportion between different parts in the nose, a technique can be selected that minimizes scarring and maximizes a pleasing proportion.

It's best not to focus on which technique you want to have done, but to focus on finding the right expert and getting their opinion based on thousands of cases they have done.

You might benefit from either one of these or both. A board certified expert in rhinoplasty surgery will be able to tell you fairly quickly what these two maneuvers will do for you. Good luck.

Dear meow1978,


You can reduce the size of the nostrils in a few ways, and the cinching technique usually does not give adequate long lasting results

For some minor changes, you can place the incisions inside the nostrils

Your best bet is to go to a consultation to review your options


Best regards,

Nima Shemirani

For this amount of narrowing and for a long-lasting result, generally incisions are your best option for alar base reduction.  This is particularly true is to need any reduction of alar base flare (excess thickness/width of the base of the nostrils).