Q: What are the pros and cons of alarplasty?

Pros Nostril reduction surgery can bring a wide nasal base into better proportion with the rest of the nose and other facial features. By itself, this relatively minor facial plastic surgery procedure is quick (about 30 minutes) and can be performed under local anesthesia, in the surgeon’s office. An alarplasty is much less expensive than a full rhinoplasty. It can be performed as a stand-alone procedure or with other types of nose surgery. Bone and cartilage aren’t touched during the procedure, so recovery time is much shorter than with rhinoplasty. Incisions are hidden in the crease of the skin, so scars aren’t usually noticeable, even up close. Cons If the skin isn’t sutured carefully, a small scar may be slightly visible. Narrowing nostrils too much can curtail airflow and cause nasal obstruction. It can also create an overly pinched nose that looks too "done." Asymmetry is also a risk. For precise results, the surgeon needs to measure the amount of tissue being removed using calipers, not just their eyes.

Question 1

What is alarplasty?

Accepted Answer

Alarplasty is a surgical procedure that permanently alters the size and width of the nostrils, making your nose more proportional with the rest of your facial features.

Alarplasty surgery that removes a small wedge of skin from the base of each nostril, to reduce the degree of flare on the outer portion of the nostrils (the ala) is also called an alar base reduction, or nose wing reduction. While this is the most common version of the procedure, board-certified facial plastic surgeon Dr. Stephen J. Pincus, who practices in Beverly Hills, explains that "alarplasty just means plastic surgery on the ala nasi, or nostrils." He points to a trend of overly-narrowed alar bases that actually need widening, a technique he frequently performs at his practice.

Whether it's done to narrow or widen the nostrils, alarplasty can be performed in combination with rhinoplasty (aka a nose job) or as a standalone procedure, if a patient is happy with the rest of their nose shape.

An alar base reduction or widening doesn’t affect the nasal tip or bridge, and it rarely affects the profile. Still, it can have a significant impact on the appearance of the nose.

A board-certified plastic surgeon or facial plastic surgeon with extensive experience in both rhinoplasty and alarplasty will be able to design the nose reshaping treatment plan that best suits your facial features, aesthetic goals, and budget.

Question 2

What are the pros and cons of alarplasty?

Accepted Answer

Pros

Nostril reduction surgery can bring a wide nasal base into better proportion with the rest of the nose and other facial features.
By itself, this relatively minor facial plastic surgery procedure is quick (about 30 minutes) and can be performed under local anesthesia, in the surgeon’s office.
An alarplasty is much less expensive than a full rhinoplasty.
It can be performed as a stand-alone procedure or with other types of nose surgery.
Bone and cartilage aren’t touched during the procedure, so recovery time is much shorter than with rhinoplasty.
Incisions are hidden in the crease of the skin, so scars aren’t usually noticeable, even up close.

Cons

If the skin isn’t sutured carefully, a small scar may be slightly visible.
Narrowing nostrils too much can curtail airflow and cause nasal obstruction. It can also create an overly pinched nose that looks too "done."
Asymmetry is also a risk. For precise results, the surgeon needs to measure the amount of tissue being removed using calipers, not just their eyes.

Question 3

How much does alarplasty cost?

Accepted Answer

The price you pay will depend on the complexity of your procedure, where you have it done, and your surgeon’s credentials, level of experience, and reputation.

Nostril narrowing is a cosmetic procedure, so insurance won't cover it.

Even though this is a less demanding procedure than rhinoplasty, it’s important not to bargain shop for an alarplasty surgeon, says Dr. Tanveer Janjua, a board-certified facial plastic surgeon in Bedminster, New Jersey. “If you end up having uneven nostrils or too-narrow nostrils, the damage can be irreversible,” he says. “Please concentrate on finding someone who can do an excellent, safe, and conservative alarplasty for you.”

See our complete guide to alarplasty costs

Question 4

Does alarplasty leave scars?

Accepted Answer

Alarplasty leaves very small, usually unnoticeable scars. “The incisions for an alarplasty are usually well-hidden, right on the alar/nasal/facial junction,” says Dr. William Portuese, a board-certified facial plastic surgeon in Seattle. “They tend to stay slightly pink for the first month or two, depending on skin type and coloration. But with time, they will heal and fade in the natural crease, making them nearly imperceptible.”

In most cases, the scar can be easily covered with makeup until it heals. You can also ask your provider about whether a topical scar treatment could be beneficial.

If the scar becomes overly thickened or otherwise noticeable, you can also consider in-office scar treatments.

To get an idea of how any residual scars will look, ask your surgeon to see before and after photos of their patients.

Question 5

Alarplasty before and after pictures

Accepted Answer

The alarplasty photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Question 6

Who’s a good candidate for alarplasty?

Accepted Answer

Any healthy adult who has wide nostrils with "alar flare" can be a good candidate for an alarplasty, says Dr. Nima Shemirani, a board-certified facial plastic surgeon in Beverly Hills, California. “Surgeons often measure the width between the inner corners of the eyes as a guideline for how wide the nostrils should be,” says Dr. Shemirani. “Depending on ethnic differences, you may want a slightly wider nose, but in general, this is a nice guide.”

If you smoke or use other nicotine products, your surgeon will ask you to stop two to six weeks prior to surgery. All forms of nicotine inhibit healing and increase the risk of complications.

During your initial consultation, your surgeon may use 3D imaging to help you visualize the effects of potential changes. This technology can also help communicate the nuances of your aesthetic goals—alar width, flare, and nostril show—to your surgeon. Not every office has this capability, so if it's important to you, ask about it when you schedule your consultation.

Question 7

How does an alarplasty procedure work?

Accepted Answer

The procedure can be performed alone or in combination with a rhinoplasty.

As a stand-alone procedure, it can be done under local anesthesia, in the surgeon's office—a much more affordable option than having general anesthesia in a surgical center. It usually takes less than an hour. Here’s what to expect.

First, your surgeon will carefully mark how much tissue to remove from each nostril, using calipers to ensure that the measurements are exact.
Then a local anesthetic will be injected. If you're feeling anxious, you may also be given an oral sedative.
Once you're fully numb and comfortable, your surgeon will make a small incision (from the inside or out) at the base of the nose, along the crease between your nostril and cheek.
They will remove a small wedge of soft tissue at the base of each nostril.
Finally, they'll secure the incisions with tiny, exact sutures.

If an alarplasty is done at the same time as a rhinoplasty, nostril reduction is usually the last step because the shape of the nostrils can be affected by other aspects of a rhinoplasty.

Question 8

How long does alarplasty take to heal?

Accepted Answer

Alarplasty healing and recovery involves about a week of social downtime, though you should feel fine to go about most of your normal activities.

“There’s usually no bruising, and swelling is minimal enough that no one will notice,” says Dr. Shemirani. “The sutures may be visible, as the only telltale sign of surgery, during the first week.”

The sutures are usually removed five to seven days post-op, depending on your surgeon's preference.

Most patients have minimal discomfort during recovery and need only over-the-counter pain medication during the first few days. Ask your surgeon what they recommend.

You’ll also be given instructions on how to gently clean your incisions and reduce the risk of infection.

As for results, you'll see a change in the size of the nostrils immediately after surgery, but your results will become more evident over the next two weeks as any swelling resolves. Avoid vigorous exercise or other strenuous activities during this time, to help reduce the swelling.

You'll see your final result about four weeks after your procedure.

ALARPLASTY

William Portuese, MD

Karyn Repinski

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William Portuese, MD

Karyn Repinski

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