Another Alarplasty Only Question. Is an Alar Reduction Alone Possible? (photo)

Question

I am trying to avoid going under general anesthesia since I now have high blood pressure. Do you have any alarplasty only pictures of noses like mine?

Kenneth Hughes, MD · Answer

Usually an alarplasty by itself can give the appearance of a widened tip and tip work is needed at the same time. In addition, the dorsum may need to be addressed due to nasal width after other aspects of the nose are narrowed. The decision needs to be made jointly with your plastic surgeon. I have plenty of pictures of noses like yours, but very few have received alarplasty alone for the reasons stated above. Kenneth Hughes, MD Los Angeles, CA

Ira D. Papel, MD · Answer

Sure, an alar reduction can be done if all else in the nose is in harmony. The alar surgery can reduce the size of large nostrils, or reduce the "flare" of the nostril to the outside. Although the results of this procedure can be subtle, in some people it is just the right thing.

David W. Kim, MD · Answer

The shape of the tip and base of the nose should look triangular in order for the nose to look balanced.  If the ala are narrowed and the tip is left the same, it created a squarer or more bulbous shape to the base of the nose.  In some noses in which the tip is relatively narrow already but the ala are flared, alar reduction as a stand alone procedure can be helpful.  For your nose, since your tip is somewhat wide, I would not recommend alar reduction unless tip reduction was also performed.

	 

	These aesthetic concepts are described in a video I created about nasal tip aesthetics in the link below.

Kimberly Lee, MD · Answer

Alar base reduction is a common request from patients, especially when smiling causes the nostrils to flare out wider. This procedure can be performed under local anesthesia. Please consult with a board certified specialist who can assist you in achieving the results you seek.

William Portuese, MD · Answer

An alar plasty can be performed as a stand-alone procedure under local anesthesia in the surgery center. The alar plasty will simply reduce the size of the nostrils bring the place of the nose inward and to be more narrow.Please see our website for examples and we also have additional pictures in the office

Stephen Weber MD, FACS · Answer

Absolutely. An alarplasty can be performed in the office under local anesthesia. Your issues with high blood pressure should not create any problems with the procedure. Further, as long as you have reasonable expectations for the expected result, an alar procedure alone can provide significant results in the properly-selected patient.
	When choosing a plastic surgeon to perform this procedure, ensure that they have experience with alar modification. In experienced hands, the procedure is predictable and provides aesthetically pleasing results. In inexperienced hands, alar surgery can create significant problems that can be incredibly challenging to remedy during a revision procedure. I hope this information is helpful.Stephen Weber MD, FACSWeber Facial Plastic Surgery

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

	You can definitely  have alarplasty alone under local anesthesia. High blood pressure is not a contra-indication to rhinoplasty of any kind and/or anesthesia.

	But to put your mind at ease, this can be done under local. See weblink below.

	Best.

	Dr.S.

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