Scarless Method for Alar Base Reduction?

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.

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

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.