Is there a procedure that can reduce the size of the alar without affecting the nostril? (Photos)

We have to clearly distinguish 2 key concepts:
-alar reduction: it is aimed to reduce the flare of tha alae when they are actually oversized, I repeat oversized for good and not expanded laterally due to nasal tip lacking length and support (like in asian noses); the cut is made at the junction of the ala and the face, this maneuver won't modify the nostrils; it is (in some degree or absolutely) contraindicated in flattened tips due to iatrogenia or ethnicity
-nostril reduction: this is done to reduce a nostrils that, again I must emphasize, is too large FOR REAL, and not virtually large due to alar retraction, columellar show or flattened and unprojected tips (like in the aforementioned ethnicities and after iatrogenia); the incision is made at the nasal sill and is hidden withing the nostril vestible and the tip of the comma spans to the base of the nose laterally; again, this is contraindicated when it is not a real enlargement of the nostril

Additional concepts:
-a combination of both: alar flare and nostril size are reduced en bloc, however to deem this aggressive maneuver indicated the surgeon has to reassure himself the proper understanding of the case; commonly done in african noses
-partial indication / partial contraindication: the nasal tip may be flattened and lacking projection and support, so in a revision or ethnic rhinoplasty the nasal tip and length are normalized, hence the tip recruits skin from the alae and nostrils, leading to an enormous reduction in alar flare and normalization of nostrils shape and size; then, at the very end of the surgical procedure, the surgeon may asses there is still a REAL and slight excess of alar flare / nostril size, practicing a very conservative and adapted-to-the-new-nasal-structure resection there

Hope I've helped to understand this topic.

In my opinion you need an asian rhinoplasty to normalize your tip, all the flare you dislike will vanish afterwards; if you get a resection of the alar flare now this will lead to very unsightly outcome, functional breathing issues and eventually irreparability of the asian tip in the future.

The width of a nose should be the width of an eye. Based on your up close frontal photo, you do not appear to have flaring of the bottom of your nostrils, and they simply do not appear to be too wide to consider surgical intervention and adding scars. I hope this helps. Sincerely, Dr Joseph

Alarplasty can be done to narrow the width without effecting the circumference of the nostrils. The key is to not enter the nasal sill or vestibule and stop the incision right at the junction of nasal sill and alar groove.
Regards
Dr. J

Hello and thank you for your question. Rhinoplasty with tensioning of the tip may accomplish what you are looking for. I do not like to make external alar base incisions as they leave very visible scarring and can change the shape of the nostrils in an adverse manner. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon