Do I Need Alar Base Reduction Too?

I am not sure if i want to get my nose tip slimmed along with my nostrils narrowed for Rhinoplasty. Would I have a piggy nose if I did have my nostrils done, as I am quite ok with the tip? I just don't like my wide nose, but want to do the minimum as I am scared of scars, redness, and recovery time. If I have the tip done, as I hear alar reduction is a small procedure, will I look normal within 2 weeks with no redness or swelling?

Doctor Answers 7

Alar reduction - what to expect

Alar reduction or weir wedge resection is a good choice for reducing the width of the Alar base (width of base of nose).  However it does leave scars, though the scars are very faint and fall into the crease where the Ala meets the cheek.  The scars are usually not visible unless one is closely inspecting, and sometimes even then cannot be seen.  The incisions can take a while to heal, so do not count on being presentable in two weeks.  You may be well healed by then, but often these incisions can take weeks to heal completely.  An alternative to Alar base resection is a cinching suture across the base to narrow the nose.  It is not as effective but does not leave external scars.  Swelling can take several weeks to go away.

Beverly Hills Plastic Surgeon
4.7 out of 5 stars 26 reviews

Redness and swelling from alarplasty can last up to a couple of months

According to the picture that is presented here, it is not a good idea to have alar base reductions because of the nature of the very small nostrils that are present. An alarplasty will reduce the airflow dynamics through the nose and create a breathing obstruction. Even if you were to undergo an alarplasty, the redness will last upwards of a couple of months and will not look perfectly normal within your two-week timeframe for no redness or swelling.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews


It is impossible to give specific answers without seeing pictures of your entire nose, but let me answer your last question. If you want to look normal within 2 weeks "with no swelling or redness", don't do the surgery. Remember the results will last a lifetime. Do your homework, get consultation(s) with rhinoplasty specialists, and have your surgery done without time restrictions.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Need a full face photo


the alar base width is something that should be in balance with the rest of your face, and can usually be aligned with the inner corner of your where your eyelids come together (medial canthus). This procedure is not without risk and can certainly leave scars on the outside of your nasal ala and you could run the risk of loosing the natural alar cheek groove leaving you with an unatural look. If warranted you could consider a sill procedure which is a reduction in the inside floor of the nose if it is wide and you ony seek a small base reduction. All things said, be careful with a base narrowing procedure.

Robert Schwarcz, MD
New York Oculoplastic Surgeon
4.4 out of 5 stars 22 reviews

Alarplasty is irreversible so exercise caution

Once tissue has been excised to narrow the alar base of the nose or the nostrils, there is nothing that will reverse the result. When I am not certain whether or not to do this procedure, I will stage it and come back in six months when I have determined what the tip looks like after all swelling subsides. This is the conservative approach.

From the single picture shown I actually do not think that alar reduction will be needed in your case, but as my colleague pointed out this may be a personal decision.

S. Randolph Waldman, MD
Lexington Facial Plastic Surgeon
4.9 out of 5 stars 18 reviews

We need to see more than just the tip of your nose

Alarplasty is a common procedure performed to slim wide or flaring nostrils. It is used as a adjuctive procedure to rhinoplasty. However, the shape and width of your nostrils need to be balanced with your face, which is not visible in your photograph. I published an article in the Archives of Facial Plastic Surgery on this topic. External incisions are used, but they are rarely visible to the untrained eye.

What is most important, is to seek a rhinoplasty specialist who can discuss all the options associated with rhinoplasty. It would be a mistake to do only part of an operation if more is necessary. This is going to be the nose that you will likely have for the rest of your life. A few small, usually barely visible, incisions should not be avoided if it will give you a superior result.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 125 reviews

Alar base reduction


This is NOT "I need" surgery - This is "I want" surgery.

Your nostrils ARE flaring and could be nicely narrowed with a WEIR EXCISION. But - as we discussed in response to one of your other posts, this IS a surgical procedure which IS associated with scars (like ALL surgical procedures).

You state you are "scared of scars, redness, and recovery time" - These scars USUALLY heal well and recovery time is usually minimal. If everything goes well, you should look well in 2 weeks. BUT - what if you have a complication such as scar hypertrophy or infection? These are possible but not common.

You need to be realistic about the risks and benefits of what you are trying to achieve. If you are NOT willing to risk any complications, regardless of hoe rare - do not have the surgery.

Hope this was helpful.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 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.