Alar Base Reduction or Tip-plasty...or Both?

I have been advised that an alar base reduction may need to be performed in order to reduce the width of my nose, however is it possible to avoid having this done if a tip-plasty is performed (my tip has little support and will need to be sutured for support) as I am worried that my nose will appear more bulbous? How much difference can be expected if the cartilage is reduced as aprently this should reduce the ‘fullness’ in the tip of my nose?

Doctor Answers 10

Nasal Tip Narrowing, Reduction of Nasal width or Both?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi Sal,

Thanks for posting the picture. You may need both tip plasty as well as alar base reduction to create a natural result.

More specifically, as you probably have noticed, your Right nostrils appears wider. At least some correction is needed to make both nostrils more symmetric.

Also increasing the projection would give the illusion or appearance of narrower or more proportionate nose.

Make sure your plastic surgeon listens to your desires and spends enough time discussing various options. You can have a great result without significantly visible result if you desire a natural outcome.

Hope this was helpful.

Dr. Sajjadian

Orange County Plastic Surgeon
5.0 out of 5 stars 205 reviews

Go to a Plastic Surgeon who will show you changes on the Computer in advance.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If you want to plan the outcome of your rhinoplasty, go to a Plastic Surgeon whoj will show you several possibilities on the computer before surgery so you can decide what you want to have done. You will then be more in charge of the final appearance of your rhinoplasty.

There are many different techniques that can be employed in a rhinoplasty, so you want to work out with your surgeon exactly what you want to have done before surgery.

G. Gregory Gallico III, MD
Boston Plastic Surgeon

Tip Narrowing combined with Alar Base Reduction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Alar base reduction may be performed for nostrils which are wide or flare out too much. Alar base reduction may be performed at the same time of the initial rhinoplasty, or later once healed. Tip plasty or tip rhinoplasty will change the alar base proportion to a certain degree, as the tip projects away from the face more or pulled closer to the face. The plastic surgeon will determine the appropriate amount of nostril skin excision at the end of the rhinoplasty procedure. Conservative skin is excised from the nostrils, as small changes may make noticeable improvements in nasal proportions. Speak with a rhinoplasty surgeon to perform a comprehensive evaluation and to help determine appropriate options.

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

Nasal tip plasty first alar base reduction if needed later

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for your photograph in question.  A nasal tip rhinoplasty or tip plasty will significantly change the appearance of your nasal tip.  A strut cartilage graft will elevate and rotate the tip upward and cartilage resection and cartilage graft will narrow the tip significantly.  In my experience this is all that many patients need.

If an alar base reduction is needed after your tip rhinoplasty in my opinion it is better done as a second procedure.  The tip plasty relies on blood supply from the alar base area and to do both procedures together in my opinion risks healing problems based on interference with blood supply.

Alar base reduction or tip-plasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The alarplasty is performed to make the nostrils less full and wide. This can be performed at the same time of tip rhinoplasty surgery. Most tiplasty surgery involves suturing the tip cartilages together to remove tip cartilages where they are simply too wide. Occasionally structural support grafts are used in the tip. Cartilaginous structure graft of the tip will not be of any width, just projection and strength. The dome binding suture and the alarplasty will make the tip look less bulbous.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Alar Base Reduction & Tip-plasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It appears you would benefit from both tip refinement and narrowing of the alar base. Tip support should be improved if necessary.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Both alar and tip reduction would be best.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Just reducing the tip will make the base look wider and vv.  You need both done by an experienced rhinoplasty surgeon,

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

Tip plasty and/or alar bas resection

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

A tip plasty and or tip graft may soften the nose a bit, but evaluating the alar base usually in a worm's eye view gives the surgeon the answer to whether or not alar base excision is called for.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Surgery on tip will help determine shape and size of nostrils

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Please be advised that your nostrils are uneven as your right appears larger than your left. Making the tip of your nose smaller will make your nostrils appear larger and a reduction may be adviseable. Making your tip project more, may give the illusion of smaller nostrils. Therefore it really depends on what is being done to the tip.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

You may need alar reduction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The surgeon will decide during the surgery if you need the alar reduction.If the patient has a very large alar base, the decision is made before the surgery.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 152 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.