Is there a structural danger when overdoing alarplasty?

Question

It seems 5 or 6 mm is the max that can be removed at any one time. Why is this so? Apart from possibly looking aesthetically unnatural, is there structural danger to removing too much of the alar base? What if you do a second alarplasty? Thank you!

Jose M. Soler-Baillo, MD, MS · Answer

Narrowing the alar flare too much can distort the natural proportions of the nose making it appear like snout rather than a nose. All the best,Dr. ResultsMiami, FL

Jason Litner, MD · Answer

If you look closely at the nostrils, the nostril base where it meets the cheek is the only part of the nostril that has a true curve to it. Removing too much nostril tissue here can result in removal of too much of the natural curve of the nostril, leaving you with a tethered, stuck down, triangular shape that looks unnatural. Your surgeon can best show you how far you could go with alar reduction and still look good.

Stephen Weber MD, FACS · Answer

There are two potential issues. First, over resection of the nasal base can create an overly pinched and surgical looking nose. Second, over narrowing of the nasal base can block airflow into the nostrils and cause nasal obstruction. To an experienced rhinoplasty surgeon, it is typically clear how much tissue needs to be removed and where. Alar base modification is particularly complex and should not be trusted to someone who dabbles in rhinoplasty surgery. The results can be disastrous in inexperienced hands. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Brian J. Reagan, MD · Answer

Over-resection of the alae can distort the normal curvature of the alar groove.  Better to be conservative .  If alar resection is being performed to reduce the nostrils, overresection can lead to airway incompetence.  So again, best to be conservative.  Computer imaging of expected rhinoplasty results is a great tool to ensuring that surgeon and patient are on the same page.All the Best,Dr. Brian Reagan

William Portuese, MD · Answer

There is only so much that can be removed from the base of the nostril. Removing too much skin will cause an unnatural appearance and nasal obstruction.

Brooke R. Seckel, MD, FACS (retired) · Answer

The concern about resecting too much of the ala is that it can restrict the airway and make breating through your nose fifficult.

Is there a structural danger when overdoing alarplasty?

Answers (6)

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