Alarplasty, often called alar base reduction, is a targeted cosmetic surgical procedure designed to refine the lower portion of the nose. This operation focuses on altering the size and shape of the nostrils to improve facial symmetry. It is considered a less invasive alternative to a full rhinoplasty, concentrating solely on the soft tissues at the nasal base. By precisely removing tissue, the surgeon reduces the width of the nose when viewed from the front. This permanent modification brings the nose into better proportion with an individual’s other facial features.
Defining the Aesthetic Goal
Alarplasty addresses aesthetic concerns like alar flare or excessive nasal base width. The alae are the fleshy, curved outer walls of the nostrils that connect the nose to the cheek. When these structures extend too far laterally, the nostrils can appear wide or “flared,” making the nose seem to dominate the central face.
Ideal nasal proportion suggests the width of the nasal base should not extend beyond the imaginary lines dropped vertically from the inner corners of the eyes. If the alar base width exceeds this, the nose may appear bottom-heavy or disproportionately large. The surgical goal is to narrow the distance between the alae to achieve a more harmonious facial balance.
The procedure helps to refine the nasal contour without altering the bridge or tip. The surgery is not intended to change the overall profile or projection of the nose. Instead, it offers a specific refinement to the nostril shape, which can significantly enhance the perception of facial harmony.
Details of the Surgical Process
Alarplasty is typically performed as an outpatient procedure and often requires only local anesthesia, sometimes paired with light sedation. If the alarplasty is combined with a more extensive rhinoplasty, general anesthesia may be used instead. The procedure usually takes approximately one hour to complete.
The surgeon selects the incision technique based on the patient’s specific anatomical needs, aiming to reduce either the nostril flaring, the width of the nasal floor, or both. The two primary techniques are the Weir excision and the sill excision.
In a Weir excision, the surgeon removes a wedge-shaped piece of tissue directly from the alar wing where it meets the cheek. This technique is primarily used to reduce the degree of nostril flare without significantly changing the width of the nasal floor.
In contrast, the sill excision targets the nasal sill, which is the flat, horizontal tissue at the base of the nostril opening. This approach involves making an incision along the inner floor of the nostril and removing a small segment of tissue, narrowing the overall width. Surgeons often combine the Weir and sill excision techniques to achieve comprehensive reduction of both flaring and width.
After the precise amount of tissue has been removed, the remaining edges are brought together and closed with fine sutures. The goal is to hide the resulting scar within the natural crease where the alar meets the cheek or inside the nostril floor, making it nearly imperceptible once healed.
Recovery Timeline and Scar Management
The immediate post-operative period is characterized by minor swelling and a small amount of bruising around the nasal base. Any mild discomfort is typically managed with over-the-counter pain medication. A small dressing or bandage may be applied to the incision sites to protect the area during the first day.
The fine sutures used to close the incisions are usually removed by the surgeon between five and seven days after the operation. At this point, most patients are comfortable resuming their normal daily activities, including returning to work. However, strenuous activities that could raise blood pressure or risk trauma to the nose should be avoided for several weeks to prevent complications.
Scar management begins immediately after the sutures are removed, often involving topical treatments recommended by the surgeon. While the initial healing is quick, the incision site may appear pink or slightly red for a few weeks. The scar will mature and fade over a longer period, generally taking several months to a year to soften and blend into the natural skin creases.