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

Question

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?

Ali Sajjadian, MD, FACS · Answer

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

Toby Mayer, MD · Answer

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

Otto Joseph Placik, MD · Answer

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.

William Portuese, MD · Answer

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.

G. Gregory Gallico III, MD · Answer

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.

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

Answers (10)