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Is It Possible to Reverse Alarplasty?

is it possible to reverse alarplasty? i had alarplasty and i totally regret it now! i think i had weir excision, wedges were removed from my base and also alar overhang trimmed. about 3-4mm of my overhang was removed and now i can't even see my alars anymore. i would like to know what are my options, i really want to have my old alar back or atleast anything to help minimize this deficiency. i want my old alar overhang and a bit space in my alar base

Doctor Answers 6

November 12th, 2012

Reversing an alarplasty

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Dear Ratedrko,

  • It depends on what your exam looks like
  • You may need extra length of the nostrils, and a graft with skin and cartilage can be used from the ear
  • The other alternative is to do something to open the nostril with stitches
  • You can look at both options during a consultation

Best regards,

Nima Shemirani

Nima Shemirani, MD


Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

November 13th, 2012

It is not easy to reverse alar reduction

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Alar reduction is one procedure in rhinoplasty in which the soft tissue is actually removed.  Therefore, in order to reverse it, soft tissue and skin needs to be replaced.  Doing this is difficult.  First, the tissue to be added must be stiff enough to overcome the contracture and narrowing resulting from the first procedure--this means a composite graft of skin and cartilage together.  These grafts are bulky and hard to hide. The graft can be hidden inside the rim of the nostril to restore some of the alar over-hang, but they will most likely cause some bulk inside the nostril, which could create some airflow obstruction.  The grafts cannot be completely hidden when used to restore alar flare or width.  This type of situation is one in which the "correction" creates a situation worse than the "problem". 

David W. Kim, MD

David W. Kim, MD
Bay Area Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

November 12th, 2012

Revision rhinoplasty can work.

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Hi.

But you have a very difficult problem.  The removed tissue has to be replaced, and that is usually done with composite grafts from the ears.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

November 19th, 2012

Reversing Alar Reduction Not Possible

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During an alar reduction procedure, a portion of the nasal ala (at the base, most commonly) is actually removed. Restoring that portion of tissue is not possible, however that does not necessarily mean that a revision is out of the question.

Kevin Brenner, MD, FACS
November 16th, 2012

Reversing Nasal Alarplasty

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Usually it is impossible to reverse an alarplasty  after portions of the nasal base are removed. I would need to see pictures to determine if the width or contour can be improved.

Richard W. Fleming, MD

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

November 14th, 2012

Alarplasty

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Alar plasty usually entails removal of tissue. Once that tissue is removed it is almost impossible to reconstruct it without significant scarring.

Steven Wallach, MD

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.