Is a conservative alarplasty possible? Looking for natural and conservative results to nostril flare? (photos)

Question

I'm a 28 year old caucasian female. I'm happy with the angle, projection, bridge, tip, and base of my nose. The only problem I have is the nostril flare. I'm looking for very natural and conservative results. I'm about to start making consultations and I'd like to know what to expect. Are most surgeons not confident in making this kind of finesse change?

Stephen J. Pincus, MD · Answer

My approach to a conservative alarplasty usually involves a few steps. I do not do all of these in every patient, if I am convinced on examination that one would work. Having said that, the first step would be to consider freeing the soft tissue of the lower one half of the nose from its bony attachments (degloving). This allows for a slight contraction of the lower one half without any tissue excision. Next I would consider a subnasal "cinching suture" to pull the nostrils in slightly. Finally, if I felt some additional narrowing was needed, I would do a minimal excision of nasal floor &/or alar wall.

Donald B. Yoo, MD, FACS · Answer

A rhinoplasty specialist will be able to comprehensively address the issues you have with your nose. Alar base modification is an effective way to reduce the flare and/or width of the nostrils. Excess width can be reduced with sill incisions, excess flare with Weir incisions, and excess flare + width addressed with a combined Weir+sill incision.  This would also heal incredibly well if meticulously performed.  In the hands of an experienced surgeon you should get a very nice result. Good luck! @drdonyoo

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi Maddy! Alarplasty is a great solution to excess nostril width and flare. Incisions are made on the underside of the nostril and a pre-determined amount of skin is marked for excision. Typically, a natural result involves reduction between 2-3 mm per side. The reason to be conservative is to prevent the nose from looking pinched. If done well, the scars heal nicely and the recovery is mild. This can be done in office under local anesthetic only. I think your approach of finesse is a perfect mindset going into this procedure. Hope that helps!

Is a conservative alarplasty possible? Looking for natural and conservative results to nostril flare? (photos)

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