Advice on nostril reduction? Surgeon said he wanted to do an alar base reduction (Photos)

A combination of a Weir with nasal sill excision will create the optimal outcome for you given the excessive width of your sill, but also the excessive flare of your ala. Preserving the appropriate degree of flare and width will allow for a significant improvement in the shape of your nostrils while maintaining a natural appearance that is not pinched.

Alarplasty can be sill excision, weir excision, nostril base reduction, suture cinching technique etc. It can be confusing enough for surgeons let alone patients.
When I do the excision it usually has a component of the nostril edge near the groove and also small portion of the sill. In your case the sill is not the issue IMHO.
A medium sized alarplasty should do the trick.

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 mimic 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.

Based on your tip photo, you appear to have asymmetrical and flaring nostrils. The asymmetry may be due to a deviated nasal septum. If you are planning to undergo a septo rhinoplasty procedure, I believe that artful narrowing of your nostrils would reduce the flare and may lead to a less distracting nasal appearance. I hope this helps. Sincerely, Dr Joseph