Do You Recommend Augmentation Implant or Just Plain Alar Reduction? (photo)

Hello thanks for viewing,I have been wanting to do this for over a decade but I just dont know what the problem is . My mom tells me that it would be ugly to reduce the alar, that I should just opt for an implant to augment the bridge cause she says it will raise the sides of my alar, reducing the ridiculous flare (it looks like mickey mouse ears). I want the alar trimmed but I am scared if the results are bad, its irreversible. Whats the safest approach? I really hate the flare. Please help!:(

Doctor Answers 5

Nostril reduction must be done conservatively!

I agree with your mother that you must be careful when considering alar reduction for the following reasons:

  1. When overdone, alar reduction can give the most unnatural results.
  2. The curve of the nostrils is important for the character of the nose.
  3. Often the "width" of the nose can be improved by adding definition to the tip and augmenting the bridge.

When considering alar reduction, make certain you consider your bridge and tip first, and if you do reduce the nostrils, be conservative!

Good luck in your search for information.

Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 105 reviews

Alar Base Reduction and Bridge Augmentation

It would be easier to answer your question with a profile view and a picture of the base of your nose. An alar base reduction would be beneficial. I understand your concerns, but select a surgeon who shares your aesthetic tastes which can be determined by looking at the results of previous similar patients. Most patients like yourself do have some augmentation of the bridge but I cannot tell without the profile view. I prefer to use the patient's own cartilage rather than an implant to increase the projection of the radix or bridge.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Do You Recommend Augmentation Implant or Just Plain Alar Reduction?

It's difficult to assess whether you need a dorsal augmentation but you would benefit from an alar width narrowing or horizontal reduction. You can send your pics through the link website below and I will image them for you.
Dr. S.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 272 reviews


Your posted photos show a wide alar base and a low radix. You could benefit from a graft or implant to the bridge (or possibly just the radix) and a narrowing of the alar base. The alar base incisions are not that noticeable if placed appropriately. Most plastic surgery is designed for conversational distance of about 3 feet. If you look in a mirror that is only a few inches away you will always see the scars. A implant or graft to the bridge will not reduce the flare. The reduction involves removal of a wedge of skin along the lower outer edge of the nostril. It is made less noticeable by leaving a small flap of skin on the inner upper aspect of the ellipse and keeping the entire incision within the shadow area when light is directed down on the nose. That makes it harder to see the scar and decreases the risk of notching after removal of the wedge.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

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.

Aaron Stone, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 1 review

Nasal dorsal augmentation vs. alar base reduction

Hi Uluala1,

You can have a very concervative alar base reduction.  You can't really reverse it so it's good to be conservative. . .if you wanted to do a bit more much much later you could.  Keep in mind, when you smile your nasal ala will still flare a bit, even if you had an aggressive reduction.

You could start small wit just the alar reduction.  As for the bridge, it's pretty nice.  I would do minimal augmentation as most and you should probably "try it out" with a filler first.

What I see when you smile that adds to the flared look is that your tip (which is a nice tip) just minimally droops when you smile.  If you were to refine that and reinforce it with a cartilage graft it would look great.

But you know, you're nice fits your face.  Make sure you consult with a few facial plastic surgeons before doing anything.

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 75 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.