Full alar trim/horizontal excision of alar rim to raise it & narrow tip. Is this safe? why is it not common in the USA? (photo)

After doing lots of research on alarplasty and different techniques available, i came across a different type of alarplasty called alar trim performed in the phillipines for wide broad flat noses with over hanging alars. Skin is excised horizontally across nose/alars to change its shape entirely and it seems to produce amazing results from the photos i have seen. Is there a downside to this procedure and what are the risks? I am considering traveling abroad to have this done? Thoughts?