My Alarplasty Journey

I am less than 24 hours post-op from my alarplasty and wanted to track how it’s going, as well as the process.

I have always liked my nose, but disliked my nostrils as they had a good amount of flare which I was always trying to minimize and hide.

At first I thought about and booked a rhinoplasty with a top surgeon, but in my second opinion doctor visit— with Dr. Sedgh— I realized that a full on rhinoplasty would take away my naturally refined tip and very likely not give me an improved look due to the impossibility of guaranteeing how the nose heals. In essence, he saw that I was trying to “take an A- nose to an A+”, which is never guaranteed and not what rhinoplasty should be, since perfection is not a reasonable expectation. I really respected his honesty and thorough explanation of why he felt how he did.

I asked if perhaps, because my base width was really my biggest issue, if he thought just an alarplasty would address my desires. He confidently said yes, because 1) I only needed a conservative amount (2mm each nostril) removed, and 2) I have a small, refined tip which means narrowing the nostrils won’t make my tip seem bulbous.

I felt extremely confident in Dr. Sedgh after we met; he never made me feel rushed, answered all of my questions in both medical and layman’s terms, and encouraged me to be as direct as possible about MY aesthetic desires and preferences. It meant a lot that he did not try and sell me a rhinoplasty like the other doctor when I did not need one.

THE PROCEDURE

Since alarplasty is done under local anesthesia in-office, I didn’t have to worry about fasting before the 8am appointment or needing someone to pick me up. They gave me ketamine to relax—a major help since the nasal numbing injections hurt and I didn’t want to be too aware of the fact that I was getting my nostrils chopped open. When it hit me I was feeling floaty and silly, they helped me onto the operating table, and began disinfecting my face with iodine. I don’t remember what happened after that because I drifted off to a dreamy sleep as they were cleaning me.

I think the procedure took an hour, but I just remember waking up with no pain and the very kind nurse handing me a mirror to see—

OH MY GOD, MY MOUTH WAS SO SWOLLEN.

Still high on ketamine, I said “Planet of the Apes!” and giggled, because truly while I could see my incisions and stitches which looked great, the massive upper lip and small nasal swelling ensured I couldn’t actually see the results. No worries, swelling is a part of surgery and I tend to swell a lot.

They had a delicious smoothie waiting for me when I got dressed, and the amazing staff wheeled me out to help me to my Uber. They were so accommodating and wonderful, and seemed like they genuinely love what they do.

It’s now midnight— I’ve been taking my pain pills every 3-4 hours and sleeping on the couch with my head elevated. The swelling on my upper lip is pretty much the same, but now my nose and under eyes are very swollen, which is to be expected. I am cleaning my incisions and applying the ointment regularly, staying hydrated, avoiding salt, and refraining from talking.

I fully expect to wake up in the morning looking even more like a member of the hospital staff from that Twilight Zone episode, but I am going to be patient, keep doing everything in my power to minimize swelling and promote fast healing, and stay positive!

Will update as I go :)

So far, my alarplasty post-op journey has been punctuated by cartoonish swelling that I did not anticipate and have been trying not to freak out at.

Every day something new is added to the features on my head which are swollen: immediately after the surgery it was my upper lip area, then quickly my nose got it too, then my under eyes, then my mid-face, and now my lower cheeks. The swelling seems to be settling bit by bit from the eyes down, but I truly haven’t seen my face like this since I had my wisdom teeth dug out in 6th grade.

I am almost positive half of the swelling is due to my brilliant decision to eat Chipotle the afternoon before surgery.

As for PAIN: I wake up with pain at my incisions, sort of that throbbing pain because of the swelling. I’m applying hydrogen peroxide, bacitracin, and saline spray but one nostril bled a bit last night and ached when I woke up.

Low dose Pain meds (Norco) helps, I no longer have to double up to get some rest, but the swelling has given me a headache! Icing my face may not make much of a difference to the size of my tumescence, but it does feel good.

I have absolutely no idea how to feel about my stitches at the nasal sill— to me they look chunky and uneven and scabby but I can’t for the life of me find many photos of *healing* alarplasty sutures, so I have to just assure myself that, yeah, surgical wounds are hideous for a few days.

Enjoy my wounded potato face.

I swear when I did my gobs of research on alarplasty/ alar base reduction, I did not see photos of what it actually looks like in the days after surgery; I only saw neat stitches with minimal swelling and hardly any redness in photos or TikToks, and while I get that rarely do people want to show you the gory details, I really sort of forgot that the healing process is always going to be ugly at some point.

What helps me as I heal is to read about the stages of healing after surgery, the stages the body and tissues go through in response to a trauma such as surgery. My nostrils were cut open, tissue was excised, and the skin was sewn back together in a new area. It's positively cruel! The body doesn't care how you justify your vanity; whether it's a madman wielding the blade or a double board-certified surgeon, your body is going to get angry at you while it cleans up the mess.

The swelling is 90% gone thanks to dilligent ice pack application (I actually used packages of frozen pureed organic dog food wrapped in paper towels; they stay colder far longer and can be frozen to mold to the contours of the face.) I also decided to try compression wrapping for my chipmunk cheeks and gave myself a very Steven Meisel bandaged editorial look using gauze I found in my toothbrush drawer. I'm convinced my stunt helped speed up my edema eschewal.

But now, the star of the show is my nostrils, which look like glistening raw hamburger meat sloppily wrapped in butcher twine. They throb and are quite swollen, and the idea that they will somehow heal flat and looking like my pristine natural nasal sills is terrifyingly improbably at this point. But again, I must remind myself I am in the early stages of a trauma. Just like my other traumas, it's going to take time and a lot of care and patience to start to see an improvement. And, of course, a good doctor to help reassure me.

One last thing: no one told me that such a "small" surgery would leave my body so exhausted! They really do describe this procedure as a quick lil' nip/tuck, but my body sure isn't responding that way. Any surgery that traumatizes major tissues, even if done under local anesthesia, is going to wear your body out as it tries to heal. Rest is not just a suggestion for healing, it really is a demand.