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