Alarplasty. What determines the potential of having noticeable alar reduction scars? (Photo)

Dear yujitsuAlarplasty, similar to most plastic surgery procedures is both technician dependent as well as patient dependent. You surgeon will try to give you a natural result. That result will vary based on his technical skill set and experience. You as a patient, will also state if you want a very natural result or you want a narrow base and that's your primary drive. The combination will lead to a more natural or more operated on result. Reversing/revising a poor alar base reduction is rather difficult. be careful. An internal reduction is more limited but also will look more natural. A full reduction will shortening the lenght of the ala is much more likely to look operated on.

An experienced surgeon will make the incisions in the base of the nose and not along the Alae which creates an attached look. Make sure you see a very experienced surgeon and you should have a natural look.

There are a few factors that contribute to visible or unnatural scarring following alar base excisions. One is the thickness and pigment of the skin itself; as darker and thicker skin has a greater chance for ending up with thicker scars and hyper pigmentation. This is not usually a factor however, and the more common cause is due to technical considerations. Each alarplasty is unique and the surgeon must analyze the curve, nostril shape and size, lobule thickness and alar facial groove before deciding upon how to proceed. This is a very unforgiving maneuver because once the tissues have been removed the procedure is irreversible. There are a myriad of ways in which to narrow an ala and achieve the goal that the patient is hoping for. While the amount of trauma and dissection for this procedure is minimal, the planning is crucial and depends on the surgeon's experience and focus.

Alar reduction is no longer performed on the outside of the nose wherein a unnatural appearance occurs. Recently, use of an internal incision has been utilized which avoid unsightly scars.

The placement of the incision and the experience of your surgeon will influence the shape of the nasal base and the appearance of the scar after alar reduction.