Alarplasty without modifying nostrils - is this possible?

Question

If I’m fine with the size of my nostrils, but the area surrounding my nostrils is more large and bulbous, is it possible to make this area smaller without affecting my actual nostril opening size? I think this is called an alarplasty but when I searched it, it seems to be that the alarplasty changes the actual nostril opening, which I don’t particularly want. Would a natural result still be able to be achieved, and is it more complicated/risky to do?

Tanveer Janjua, MD · Answer

Yes, alarplasty will still help but it has to be conservatively done. You don't need any nasal sill excision which effects the nostril openings size.
Alarplasty is a very fine and quick procedure that can narrow the nostrils and reduce the flare to soften the appearance. It has other names as well like ‘Weir Excisions’ or ‘Nostril Reduction’. It can be done under local anesthesia. The social down time is about a week. If you want to work from home you can start it the next day. For the procedure you are evaluated to determine how much of a change is needed. In the past surgeons had recommended 2mm to 5mm reduction. This was measured by drawing a vertical line at the lateral sides of the nostrils (alae). However, I prefer to use a mirror and Q-tips to show the patient how much of a change can be accomplished. Pushing with Q-tips from the sides can mimic the change. Patient can also pinch their upper lip near the base of the nose and will show them how much narrowing to expect. I try to quantify the change as small, medium and large. Rarely it can be extra large as well. I always advise the patients to be conservative in the change as it is an irreversible procedure. The procedure historically did not get a lot of attention in plastic surgery. It was always thought of an adjunct procedure done with a rhinoplasty. Historically most ethnic groups did not get rhinoplasties. Hence, the caucasian rhinoplasty was the main procedure that plastic surgeons were trained on. 15 years ago I started making videos on the procedure and putting them on YouTube. In my blogs I started using the term 'Alarplasty' as most doctors and patients were using the term nostril reduction or Weir Excisions. I started noticing that over years the term 'Alarplasty' became popular among patients as well. Today, most patients use the term freely and know a lot about the procedure. I am very excited to see this evolution over the years. My African American patients were especially happy to learn that you can make the nose look small without having to do a full rhinoplasty. Many of them noticed that every plastic surgeon they went to offered a full rhinoplasty. 
In summary, Alarplasty is a unique procedure in itself and hopefully more surgeons get trained in it and help more people.
You can visit our alarplasty website to learn all about it. 
Regards
Dr. Janjua

Eric M. Joseph, MD · Answer

Consider re-asking your question with a photograph, since it is not clear from your narrative what you are looking to achieve. Wishing you all the best moving forward. Sincerely, Dr Joseph

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