Would alar base reduction be enough?

Question

Or would I benefit more from doing some work on nose bridge aswell? What can you tell by just this one picture.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can
accomplish this by trimming, suturing, and reshaping the cartilage in your
lower nose. In order to better evaluate your dorsum, a true lateral profile view would be very helpful.  Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and not just a computer animation system. The most important
aspect is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Gerald Minniti, MD, FACS · Answer

Hello,Issues that bother a potential patient enough to have a rhinoplasty are many. These are subjective and very personal; the surgeon's job is to elucidate those issues and design a remedy.  Occasionally, the surgeon should guide a patient toward treating other issues as well that may contribute positively towards the patient's aesthetic goal.  In your case, I see that much improvement to your nose can happen with a more comprehensive rhinoplasty that involves the tip and bridge, not just the ala.  Go visit a few qualified surgeons for a consultation that includes digital simulation of so you can see your appearance after a proposed surgery.  Best of luck!

Evan Ransom, MD, FACS · Answer

Thank you for the question and the photo. It's very difficult to make a clinical recommendation based on a single photo... That said, an alar base reduction as a stand-alone procedure is not frequently the best solution. Your nasal tip appears a bit wide, and reducing the alar base can actually accentuate this if the tip is not addressed. Many patients have an incomplete understanding of what alar base modification does. It is best thought of as the icing on the cake of a complete rhinoplasty, allowing for a subtle improvement in symmetry after other changes have been made. Best of luck moving forward!

Toby Mayer, MD · Answer

Alar base reduction only? No. The entire nose would look to wide if you just narrow the base. Choose a very experienced rhinoplasty surgeon whose noses and reviews you like.

William Portuese, MD · Answer

An alar base reduction only makes the nostrils more narrow. The nose a is three-dimensional structure, and rhinoplasty is performing all three dimensions, so is vested have a full set of facial photographs make a determination about what you're trying to accomplish. The bridge line in the nasal tip can be narrowed. For many before-and-after examples of narrowing a wide nose with closed rhinoplasty, please see the link and the video below

Daniel Barrett, MD · Answer

Dear santalos5,it is hard to tell without an examination. I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Johnson C. Lee, MD · Answer

Thank you for your photo. Generally speaking, an alar base reduction alone will make the tip and the bridge of your nose appear relatively wider. Because the appearance of the nose is so dependent on harmony between the multiple subunits of the nose, changing one with the others does not always guarantee a "nicer" nose. It is best to have an in-office examination to determine the best treatment plan which will achieve your goal nose. Hope this helps!Johnson C. Lee, MD Plastic Surgery@drjohnsonlee

Gilbert Lee, MD · Answer

It is very important to maintain the appropriate balance in a nose. I do not think it would be prudent for you to narrow the base of your nose without also narrowing the upper two thirds of your nose.

Jeffrey Jumaily, MD · Answer

It is difficult to say from just one picture and without knowing your goals and what you like. ABR alone can make a nose look too wide sometimes if the tip is not refined as well. But it all depends on you and your goals.

Robert Singer, MD · Answer

Improving the
nostril width with an alar base reduction is a frequent request of patients wanting
nasal refinement. It is possible to improve the cosmetic appearance of the tip
alone without altering the rest of the nose in some patients. Whether the
optimal option in your particular situation would be a tip rhinoplasty alone or
an artistically performed natural appearing full rhinoplasty would best be
determined at a consultation. 
Following the advice from a surgeon on this or any other website who proposes
to tell you exactly what to do based on limited 2 dimensional photos without
examining you, physically feeling the tissue, assessing your desired outcome,
taking a full medical history, and discussing the pros and cons of the
operative procedure would not be in your best interest. I would suggest you
find a plastic surgeon with extensive nasal surgery experience who is certified
by the American Board of Plastic Surgery and ideally a member of the American
Society for Aesthetic Plastic Surgery (ASAPS) or a facial plastic surgeon (otolaryngologist)
that you trust and are comfortable with. You should discuss your concerns with
that surgeon in person.
Robert Singer, MD FACS
La Jolla,California

Would alar base reduction be enough?

Answers (12)

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