Am I a good candidate for alar base reduction?

Question

I’m really contemplating going for alar base reduction to reduce the width of nostrils as they flare a lot and I want a straighter and slimmer look but I don’t want the alarplasty procedure to give me a pinched unnatural look. I don’t want a full rhinoplasty. Can a stand alone alar base reduction achieve what I want?

Tanveer Janjua, MD · Answer

You are a good candidate for alarplasty as it will reduce the flare of the nostrils. 
Alarplasty is a very fine and quick procedure that can narrow the nostrils and reduce the flare to soften the appearance. It has other names as well like ‘Weir Excisions’ or ‘Nostril Reduction’. It can be done under local anesthesia. The social down time is about a week. If you want to work from home you can start it the next day. For the procedure you are evaluated to determine how much of a change is needed. In the past surgeons had recommended 2mm to 5mm reduction. This was measured by drawing a vertical line at the lateral sides of the nostrils (alae). However, I prefer to use a mirror and Q-tips to show the patient how much of a change can be accomplished. Pushing with Q-tips from the sides can mimick the change. Patient can also pinch their upper lip near the base of the nose and will show them how much narrowing to expect. I try to quantify the change as small, medium and large. Rarely it can be extra large as well. I always advise the patients to be conservative in the change as it is an irreversible procedure. The procedure historically did not get a lot of attention in plastic surgery. It was always thought of an adjunct procedure done with a rhinoplasty. Historically most ethnic groups did not get rhinoplasties. Hence, the caucasian rhinoplasty was the main procedure that plastic surgeons were trained on. 15 years ago I started making videos on the procedure and putting them on YouTube. In my blogs I started using the term 'Alarplasty' as most doctors and patients were using the term nostril reduction or Weir Excisions. I started noticing that over years the term 'Alarplasty' became popular among patients as well. Today, most patients use the term freely and know a lot about the procedure. I am very excited to see this evolution over the years. My African American patients were especially happy to learn that you can make the nose look small without having to do a full rhinoplasty. Many of them noticed that every plastic surgeon they went to offered a full rhinoplasty. 
In summary, Alarplasty is a unique procedure in itself and hopefully more surgeons get trained in it and help more people.
You can visit our alarplasty website to learn all about it. 
Click on the video link below to see the details.
Regards
Dr. J

Ronald J. Edelson, MD · Answer

I think you are a great candidate for an alar base reduction which can be done under local anesthesia. There are many different patterns for this procedure you might want to look at online

Steve Laverson, MD, FACS · Answer

YES, nostrils can be evenly narrowed and diminished in size by alar base reduction under local anesthesia.  However, when the base of your nose shrinks and becomes smaller, everything nearby appears relatively larger.  Proportions change.  Your lips may appear larger, often an appreciated difference, but the cheeks and tip of your nose which you like now may also appear larger.  For this reason, we often (not always) refine the tip of the nose and/or add other adjacent refinements simultaneous with alar base reduction.

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