Do I need to do the revision rhinoplasty or just alar reduction? (Photo)

I did a rhinoplasty one year ago. Including that use my own cartilage to narrow tip and bridge augmentation. But the doctor did not do the alar reduction. Since the columella has been elongated, my nostrils look bigger and more obvious than before. Do I need to do the revision or just alar reduction?

Doctor Answers 5

Revision rhinoplasty before only nostril narrowing incisions?

 Revision rhinoplasty before only nostril narrowing incisions?  if the only thing that bothers you is the width of your nostrils then all you need is narrowing of these under local  anesthesia.  However, you have a poly beak deformity and can have this corrected with a revision rhinoplasty as well. The cartilage can be reduced and the tip properly supported to give you a more feminine nose.  See a very experienced rhinoplasty revision surgeon who can show you many examples of his work with noses like yours or worse. 


Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 32 reviews

Alar reduction versus revision

Hi there,

Thank you for your question. Looking at your photos, I would lean towards an alar reduction in the office. The nasal tip and bridge look good.  If the change you are looking for is just in the ala, I think treating that area specifically makes sense in your case (the relationship of your nasal tip to the ala will still look good).

I would recommend you discuss it with your surgeon if you still have a good relationship with him/her.

Make sure you discuss where the incisions will be placed.

Good luck!

Myriam Loyo, MD
Portland Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Revision rhinoplasty or alar reduction?

Many plastic surgeons (myself included) prefer to separate alar reduction from the primary rhinoplasty procedure. The reasons are that it may not be necessary once the other modifications are made, and that it adds one more variable in asymmetry correction. Your photos appear to show good tip symmetry/projection with a straight nasal bridge. The wide nasal base width/nostril flair could be reduced with conservative alar-plasty (Weir resection). If you continue to have a good working relationship with your operative surgeon, then I would discuss your concerns with them in a post-operative consultation.

Michael F. Bohley, MD
Portland Plastic Surgeon
4.9 out of 5 stars 15 reviews

Alar-plasty to reduce the wide nostrils

An alar-plasty is performed to narrow wide nostrils. This involves removal of the wedge of skin at the base of the nostrils to narrow them. This procedure can be performed under local anesthesia with a formal rhinoplasty, or as a standalone procedure. For more information  and many examples, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Revision rhinoplasty for wide nostrils versus alar ase reduction.

If the only issues you have with the appearance of your nose is the width of the nostrils than an alar base reduction will likely suit your needs.

Adam Bryce Weinfeld, MD
Austin Plastic Surgeon
4.9 out of 5 stars 51 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.