I have a very big flat nose .. I am wondering if an alarplasty surgery and a filler can make it look nicer? (photo)

I think your nose can be improved but not with alarplasty alone.Find a plastic surgeon with ELITE credentials who performs hundreds
of rhinoplasties and rhinoplasty revisions each year. Then look at the
plastic surgeon's website before and after photo galleries to get a
sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA

In a word "no."The alar reduction may be needed but not in isolation. And I don't think fillers have any role in making your nose look nicer.If you were my patient I would ask you to consider a rhinoplasty with rib cartilage grafts. Your procedure would involve extend spreaders to closewise rotate (de rotate) your tip and reduce front on nostril show. you would also get dorsal onlay to create a bridge and make the nose less narrow. Any I would shape the tip with soft tissue thing, dome sutures, lower lat manipulation (possible reduction), and grafts.Make sure your surgeon can give you a detailed plan of what is going to be done and why. It should sound something like what I have above and potentially more detailed.

I do think fillers have a role in correction of skeletal asymmetries. I have used them for years for the nasal dorsum (to lessen the appearance of a "dorsal hump" and to smooth out asymmetries) and around the orbit for asymmetries from untreated fractures (see my picture gallery). Of all, Radiesse is my favorite for skeletal augmentation.  I am starting to use Renuva (an adipose allograft product, new to the market) with similar pleasing results. Both are difficult to get rid of, however. If you are uncertain if you'd like the results, try Juvederm or a similar straight hyaluronidase product for a sneak peak; we have hyaluronidase to dissolve it in the event you don't love it.  I do not think fillers have any effect on narrowing the base width of a nose or on nostril shape; that is treated with surgical rhinoplasty. AND--definitely have a physician (not a medspa tech/aesthetician) familiar with nasal anatomy inject it--safety is a concern. Good luck!