Am I a candidate for alarplasty or a full rhinoplasty? (photo)

Question

I would like my nose to be way slimmer especially the bottom part, the width of nostrils/wings. I would like my nose to look more feminine. I already had my tip done, it was bulbous. Do i need a full rhinoplasty or would alarplasty give me the desired outcome?

Tanveer Janjua, MD · Answer

Your nostrils are making the bottom half of the nose appear large. Alarplasty will certainly make them less noticeable and contribute to the overall appearance of the nose. 
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. 
Click on the video link below to see the details.
Regards
Dr. J

Ronald J. Edelson, MD · Answer

You have a good result from your prior rhinoplasty. If you want an alarplasty as well it can be done without redoing your entire rhinoplasty

William Portuese, MD · Answer

An alar plasty simply narrows wide nostrils, and can be performed under local anesthesia as an outpatient procedure. It's also important to make sure you don't have nasal obstruction or deviated nasal septum present, which might need to be fixed simultaneously.

Darryl J. Blinski, MD · Answer

Based on the posted photos, I would recommend a complete revision to get a thinner. More shapely knows with AR plasty. Fee for revision starts from $10,000-$20,000. Best of virtual consult with.

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