Scarless Method for Alar Base Reduction?

Hi, I'm interested in alar base reduction but worried about the scarring issue. Is there a way to avoid scars, and especially those I think I can discern in the photos I attached (red arrows)? I don't like the shape of the nostrils in sets A and B. Set C is better but scars are obvious I think I included a photo of my nose. I'm Chinese American, 25y.o. As you can see my nostril sills are quite apparent so a scar there (outside the nasal floor) would not be easy to conceal would it? Thanks.

Doctor Answers 5

Scarless Method for Alar Base Reduction?

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Alar base reduction requires an incision and every time the skin is incised, there is a resultant scar. However, there are ways to hide incisions and methods to improve scarring even in a patient with thick skin and/or more pigmented skin. Alar base reduction is not the sine qua non of Asian rhinoplasty. For many of my patients undergoing augmentation rhinoplasty, I advise them to wait on base reduction especially if a tip-plasty is performed to project the nose. Sometimes augmentation with tip-plasty balances the nose so that base reduction is unnecessary. And it is a small procedure that can be performed under local anaesthesia in the office.

Washington Facial Plastic Surgeon

Scarless alar base reduction

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The least visible scars in that area would be the use of internal sutures with release of ligaments that hold the nostrils apart. Some tissue is excised but this technique leaves the least visible scars.

Charles S. Lee, MD
Beverly Hills Plastic Surgeon
4.5 out of 5 stars 79 reviews

There is no scarless method for Alar Base Reduction!

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Unfortunately, there is no scarless method for an ABR.  To narrow the tissues requires removal of excess or malpositioned tissues.  Scars can be minimized using multiple modalities but that is a conversation best left to you and your rhinoplasty surgeon.  My experience has been that ABR incisions actually hide quite nicely in the shadow planes of the nose.  Even when sill margins are evident, as in your personal situation.  I would make sure you find a surgeon experienced with ABR procedures.  These surgeons are typically members of the American Society of Aesthetic Plastic Surgery (ASAPS) or the American Association of Facial Plastic and Reconstructive Surgeons (AAFPRS).  Members of the Rhinoplasty Society have made a special commitment to the craft of rhinoplasty and are typically very well versed in multiple techniques to optimize surgical outcomes for the nose.

Good luck,

Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 69 reviews

Asian rhinoplasty

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Yes, it is possible to reduce the alar base without scar.  I've develop a cinching stitch pull through method for this purpose.  It is impossible to discern if you are a candidate, but I suspect you are.  The wider the base, the lesser the chance this technique is appropriate.   Also, many times a patient wants the alar base reduced, but actually needs tip work.  

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 18 reviews

Alar Base Reduction

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There are ways to do alar base reduction without having a scar in the sill.  To ensure that your scar is minimized, please seek the advise of a board certified specialist in the face who specializes in Asian Rhinoplasty and Asian Alar Base Reduction.  Please voice your concerns as your alar base reduction may be performed without a scar in the sill.  Additionally there are special ways to minimize any potential scarring postoperatively.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 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.