Revision alarplasty - what procedure is needed? (Photo)

The alar rim can be lowered by adding a graft along the rim. If there is significant differences, you might need a composite graft of both skin and cartilage that is taken from the ear. This procedure takes less than half the time of a full revision rhinoplasty, which is why many surgeons charge less. However if you ahve other issues you might need a full revision rhinoplasty. You should seek out a specialist in revision rhinoplasty for an opinion.

It is easy to raise the lower rim with a rim incision and small amount of resection: the scar is not visible. To lower the higher rim is much more involved. A cartilage graft from the ear sometimes gives a good result but not always. It is more predictable to do a formal revision rhinoplasty to reorient the lower lateral (tip) cartilages and add cartilage grafts as well. In your case I am not sure that is worth it. I would seek more than one opinion with experienced revision rhinoplasty.

An alar-plasty simply narrows wide nostrils. The photographs demonstrate alar retraction, which is going to require a composite skin and cartilage graft from the ear.