What type of alar base reduction will achieve my desired look? (Photos)

I have a 16 year old Gortex implant for height and the cartilage at tip was brought together. Nostrils were not reduced. However nose is still very bulbous and nostrils are too wide when I smile. What options are there and how large/where will scars be? Last photo is the size I would like nostrils to be when smiling.

Doctor Answers 6

Alar base reduction

Dear readytoshineLA, I would be very careful when considering alar base reduction with your nose. I would suggest seeking some consultations with experts in the field and discuss your concerns and after a full examination candidacy would be determined. Personally I only use an internal incision so that there is no visible sign of the procedure. Best regards, Michael V. Elam, M.D.


Orange County Facial Plastic Surgeon
5.0 out of 5 stars 199 reviews

Alar base reduction

Thank you for your photos. In order to reduce your alar bases (bring them in to a more narrow position), you would have incisions inside the rim of your nose right where your nose and upper lip meet. The incisions are very small and not easily seen. If you also desire some tip improvement, you may need a revision rhinoplasty to reposition and resize the cartilages which form your tip. Often times, I remove the old implant to access this area and cartilage is then harvested from your septum and/or rib to create a nice bridge and refined projected tip without the need of another foreign body or implant in your nose. This is particularly common in asian and ethnic rhinoplasty. Hope this helps!

Johnson C. Lee, MD Plastic Surgery

Johnson C. Lee, MD
Beverly Hills Physician
5.0 out of 5 stars 12 reviews

Tip rhinoplasty

Alar base reductions can be done with an internal or external incision.  Yours can be done with an internal incision.  A special cinching suture would improve the result even more.  To achieve the results in the picture, you would also need the cartilages in the tip of the nose revised.  

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 11 reviews

Alar base reduction

A very conservative alar base reduction can be performed with the incision placed on the inside.  Less is better.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Rhinoplasty: alar base reduction

Alar base reduction is a rhinoplasty technique to decrease the width of the nostrils. This involves removing tissue either from the outside, inside, or full thickness. The appropriate technique would depend on the goal width and your examination (including measurements of the width and flare of your nostrils).The most important thing is to be conservative. Taking too much can make the nostrils and tip look strange. Taking too much can affect your breathing. And it's extremely difficult to make the nostrils larger after reduction. I recommend having a consultation with an rhinoplasty expert, confirm your goals with a computer simulation, and take time before moving ahead. 

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

What type of alar base reduction will achieve my desired look?

Dear readytoshineA conservative internal Weir incision can narrow your nasal sill and reduce the out-bowing of your ala. A full incision will give you an external scar that is too often too noticeable to be worth the improvement you would get in your case. You have to be careful as an aggressive alar base reduction can give you a disproportionately large appearing tip and unnatural appearing ala.  Look for an experienced and properly trained plastic surgeon, certified
by the American Board of Plastic Surgery. See more than one consultation
and make a well informed decision.

Afshin Parhiscar, MD
Bay Area Plastic Surgeon
4.9 out of 5 stars 49 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.