How Long After Rhinoplasty Can I Have Alar Reduction?

Question

Because it was too upturned, and the bridge was narrowed. I'm only 2 weeks post-op. It doesn't look narrower yet but I know there is still swelling.However, I wish that I would have had an Alar reduction. The doctor that I had the procedure with didn't think I needed it, but I had two other consults and both those doctors thought I needed it. My question is, How long would I have to wait to have an Alar Reduction after having Rhinoplasty?

Evan Ransom, MD, FACS · Answer

Generally speaking, alar modification is performed at the time of the rhinoplasty. Since the alar tissues are modified externally, and this would not involve reopening or manipulating the rest of the nose, the honest answer is that it could be done at any time. The risk is that, with a lot of swelling in the nose so soon post-op, the alar reduction may be disproportional.  For that reason, I would wait 3 or 4 months. Best of luck!

Farbod Esmailian, MD · Answer

Minimum 6 months, better if 1 year.  You really need to wait for things to settle to see all the relationships.  You also need to really be aware of the resulting scars that alar reduction produces.  It is unlike rhinoplasty where the scars are hidden.  These scars are placed in locations where they are less likely to show, but still are some what prominent.  So if you are borderline and can possibly do without, then I would not recommend it.
Good luck.

Toby Mayer, MD · Answer

Though all the welling won't be gone, enough will be to make the determination as to whether or not alar resections would be indicated for you.

Tanveer Janjua, MD · Answer

One month minimum.
One year ideal.
If you are healing well and majority of the swelling is gone, then one month is safe.  However, the shape of the nose might keep changing for the first year. That will make it difficult to assess the amount of alar reduction needed.
In summary, be patient and wait for one year.
Regards

Michael A. Persky, MD · Answer

Hi Trueblood,
At this point, two weeks after your rhinoplasty, it would be best to wait at least a few more weeks to allow the swelling of your nasal tissue to decrease.  Let your nose settle, and then re-evaluate.  Discuss your concerns with your rhinoplasty surgeon.
Make sure that your surgeon is comfortable with alar narrowing if you continue to feel that it is necessary.  If your surgeon still feels that it is not indicated, you lose nothing be waiting.  After a few months if you still disagree, then you may get other opinions.
Good luck and be well.
Dr. P

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