What Kind of Scarring Would I Have with Alar Base Reduction?

I've come to the conclusion that Id like a wedge excision procedure (just want to reduce the alar flare without reducing nostril size). However, there seems to be a lot of concerns with the wedge procedure as it leads to some external scarring. I wouldn't mind this if the scar itself was camouflaged with the alar crease. My main concern is the obliteration of the facial alar groove with this procedure. Any thoughts on this? Whats the best way to go about this without obstructing the alar crease?

Doctor Answers 6


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I have not noted obliteration of the facial alar groove in my patients or those done by other surgeons. I have seen visible scarring because the incision was carried to far up the side of the nose or too far from the crease where the nostril rim meets the upper lip. The latter was the case of a well known respected rhinoplasty surgeon.

I have found making sure the outer corner does not go past the shadow from direct overhead lighting and leaving a small flap of skin on the inner corner of the ellipse (so it is not a true ellipse) to be the most helpful in achieving an optimal result.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Los Angeles Plastic Surgeon

Scarring with Alar Base Reduction

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By placing the incision in the proper location above the groove, there is no risk of obliterating the alar facial crease. You have drawn the excision in the proper position; I hope you are as good a technician as you are an artist. Do not be concerned about the wedge procedure. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 42 reviews

Alar base procedure

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Alar base procedures can be to reduce the flare or the nasal base width. When performing this procedure you try to maintain the groove just as you stated.  Actually the incision is made just above the groove to maintain that natural curve.

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

Scarring with alar base reduction.

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In 35 years Ihave never had to revise any alar base excisions. If you see an experienced rhinoplasty surgeon you should not have a problem.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Alar Base Reduction

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The scars for alar base reduction are placed into the shadow of the alar crease to minimize any visible scarring.  If done correctly, alar base reduction should not obliterate the facial alar groove as it is recreated when the incision is sutured back together.   Please consult with a board certified specialist who can best assist you in achievingthe results you desire.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Alar base reduction

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When performing an alar base reduction (ABR) with a wedge excision removed from the ala, it is critical to leave a 1mm rim of alar tissue against the face that the surgeon will sew to.  If the wedge is taken out flush against the face, you run the risk of obliterating the alar facial groove/crease, as you say.  Hope this helps.

Jason D. Bloom, MD
Philadelphia Facial Plastic Surgeon
5.0 out of 5 stars 25 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.