One alar base is higher than the other. Would raising the lower side with an alar base wedge resection be most sensible? (photo)

Question

Hello, One of my alar bases is higher than the other, which makes my nose and nostrils appear quite asymmetrical. I’m wondering what the most feasible way to correct this would be. Would raising the lower side with a alar base “wedge” resection make the most sense?

Ronald J. Edelson, MD · Answer

I perform alar wedge resection quite commonly and I like them.  In your case it could be done under local anesthesia.  You could do only one side, see how it looks, then consider whether the other side needs it,  all while being awake.

Suleyman Tas, MD, FEBOPRAS · Answer

Hello,
Thank you for your question. Based on your photo an alar base retraction can be corrected without an alar base wedge resection with the help of the technique developed by me. 
Depending on the amount of alar base retraction and deviation of the nose, it can be corrected by the dissection of the LLANM ( levator labii alaque nasi muscle) musle, rim grafting and alar base release. An in person examination can provide best options for you. To find out more please click on the attached link. 
Best Regards

Michael Kulick, MD, DDS · Answer

Achieving symmetry is not an easy thing to do nor a reality in the most strictest sense. Your observations are correct. However, it is easier to lower vs. raise an alar base in my opinion. If this makes sense to you then a consultation is what you need to do next. Hope this helps,Michael Kulick MD, San Francisco, Ca. 
   Board Certified Plastic Surgeon

Member of ASPS, ASAPS
   Recipient of the Klingbeil Award from ASAPS – Teaching Safe Techniques and Advanced Technologies

Kimberly Lee, MD · Answer

Uneven nostrils are a common concern amongst patients.  Instead of doing a wedge resection, which could potentially make the nostrils more uneven by thinning out a side, it may be more desirable to just reposition the alar to be more even with the other side.  Please consult with a board certified specialist who can assist you with achieving the results you seek. 3-dimensional computer imaging can help you visualize what you may look like afterwards and serve as a good communication tool with your surgeon.

Barry L. Eppley, MD, DMD · Answer

The critical question is which is the 'goal' alar base which I assume by your inquiry is the lower left one. You are correct in that it can be raised with a slightly higher scar tendency than it is to lower the higher one.

Richard O. Gregory, MD · Answer

There is asymmetry of the nostril sill and alar rim.  There are several approaches to improving this(notice that it does not say correcting it as I suspect that absolute symmetry would be unlikely). Raising the lower,more caudal side would probably give the best result because the alar rim could be reduced at same time.  The scar would be noticeable but would improve with time and could be revised or lasered later.

One alar base is higher than the other. Would raising the lower side with an alar base wedge resection be most sensible? (photo)

Answers (6)

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