How much would it cost to fix my alar retraction? What would it involve? Closed or open rhino? (photos)

Would it be possible to get results like the man in the pic with no columellar show?

Doctor Answers 5

Alar retraction

There are various ways, techniques, and approaches to address and improve alar retraction. All of them involve some sort of cartilage grafting to bring the alae down and keep them down. You should see a board-certified rhinoplasty expert for a consultation to discuss your best option. Good luck!

Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Composite skin/ cartilage grafts for alar retraction

To reduce alar retraction requires a composite skin graft composed both  cartilage and skin harvested from the ear. The grafts enable the alar rim to be pushed downward to a more natural position.. In addition, the  hanging columella can be reduced as well.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Alar Retraction

Thank you for your question.  Alar retraction poses challenges even to the most experienced of rhinoplasty surgeons.  I would definately seek only the advice of someone that specializes in the face like a Double Board certified Facial Plastic and Reconstructive Surgeon.  The issue you have can be addressed either with conservative lifting of the columella (central peice) that would give the impression of less retraction or you could certainly do a alar batten graft.  Either one can be done via endonasal or external approach.  Hope this helps.

Roberto E. Garcia, MD, FACS
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews


Hello and thank you for your question. Based on your photograph, you may benefit from alar batten grafts.  This can be performed with either open or closed technique.  Cost varies based on geographic region and surgeon expertise. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 124 reviews

Alar retraction

In my opinion, your alar retraction can be improved via a closed approach using alar rim cartilage grafts harvested from your septum. Please notice I used the word "improved" -- to achieve a result closer to that of the photo you supplied may likely require a "limited" open approach for placement of articulating alar rim grafts. These articulate off of the nasal tip and more effectively "push" the alar rims down. 
Total costs for this outpatient surgery in my fully-accredited in-office OR would be around $3,000.
Best wishes!  Harry V. Wright MD, Sarasota, Florida

Harry V. Wright, MD
Sarasota Facial Plastic Surgeon
5.0 out of 5 stars 32 reviews

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