Alar Base Reduction Techniques?

I have read several answers to posts regarding alar base reduction and would like to know if the cinching suture technique can obtain results of reducing the width of the base of the nose/nostrils by 2mm on each side (3-4mm narrowing total) , or if a weir incision technique will only do this, or perhaps a combination of the two together?

Doctor Answers 16

Alar Base correction

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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. 

Alar Base Reduction should be successful with Weir or Wedge Technique

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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.

Alar Base Reduction

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   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

Alar base reduction with cinching suture

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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.

Techniques for Nasal Alar Base Reduction

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Sutures can be used to reduce the width of the alar base but an accurate individualized excision of the excess base will provide a better result. In most cases it is  better to remove excess tissue than simply rearrange it .

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

Alar reduction

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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.  

Alarplasty is tricky

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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.


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.

Cinching suture

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We do not use the cinching suture technique due to unfavorable results we have seen performed from other offices.  We have seen unnatural results of bunched up upper lip/philtrums and a break in the sutures.  Best to perform a simple, conservative alar-plasty in experienced hands

Alar base reduction and cinching

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A cinch technique can narrow the base by using a suture to basically pull the nose inward from the middle.

Alar base reduction

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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.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 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.