Rhinoplasty techniques for alarplasty? (Photo)

I think you are a great candidate for an alarplasty.  This involves excision a crescent of skin along the nostril crease and extending into the base of your nose.  There are so many different ways that this could be done.  I find that most surgeons are too conservative regarding the size of the skin removal.  If the excision is too small you will not see enough of a change.

You have a round tip, widened alar base, a retruded columella and a low bridge. Your expectation photos are a romanesque nose with a defined bridge and tip. If you only do the alarplasty you will not get anything close to what you are looking for. You are going to need bridge augmentation, tip cartilage grafting and possibly a septal batton or nasal spine button graft to move the bottom of the columella outward to get close to what you are looking for. Lifting the ala is not the solution. The problem is the columella retrusion and the alar left to right width.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 in order to know if this assessment is valid.

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. You may also benefit from an alar base reduction.  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. FACS
Harvard-trained plastic surgeon