As a board-certified facial plastic surgeon with extensive experience in both aesthetic and functional nasal surgery, Dr. Ritchie Younger understands the intricacies of nostril anatomy and how to optimize the proportions of the alar base. Whether performed alone or in conjunction with a full rhinoplasty, alarplasty requires a skilled and artistic approach to achieve natural-looking results that enhance rather than distract from the patient’s unique features.
What is Alarplasty?
Alarplasty (also known as alar base reduction) is a cosmetic surgery that changes the shape and width of the nostrils. The alar base is the lower portion of the nose that connects to the upper lip and cheek. It’s the triangular outline you see when looking up at the nose from below.
Although often inconspicuous, the alar base plays an important role in the proportions of the face. For example, when it is too big, it might seem out of balance with the mouth, cheeks and eyes. Overly wide or flaring nostrils can also detract from other pleasing features and cause some to feel dissatisfied with their overall appearance.
Alarplasty aims to reduce the size or width of the nostril base. It can be performed on its own or combined with rhinoplasty for more comprehensive results. As a standalone procedure, alarplasty uses small, discreet incisions at the base of the nose to narrow the nostrils and improve facial symmetry — no bone reshaping is necessary. This means a shorter recovery and less downtime than similar procedures.
Some of the most common concerns that can be addressed with this procedure include:
- Overly wide or flaring nostrils that dominate the face
- Elongated or drooping nostril shape
- Asymmetrical nostrils (one larger or differently shaped than the other)
- Excessively curved or notched nostril rims
- Nostrils that are disproportionate to the nasal tip or other facial features
How Does Alarplasty Differ from Rhinoplasty?
Rhinoplasty is a surgical procedure that makes a wide range of structural changes to the nose, altering its size, shape, angle or proportions to bring it into harmony with the rest of the face. It can be done for aesthetic reasons or to improve functionality if breathing issues occur.
Compared to alarplasty, rhinoplasty is a more invasive procedure that often involves reshaping of the bone and cartilage to achieve a desired result. Alarplasty adjusts the width of the bottom portion of the nose to improve nasal symmetry, requiring only minor incisions to remove a small wedge of tissue in the alar base.
Ideal Candidates for Alarplasty
Alarplasty can be an excellent option for individuals who are bothered by the size, shape or symmetry of their nostrils but otherwise satisfied with their nasal appearance. The ideal candidate for alarplasty is a non-smoker in good overall health with realistic expectations for improvement. It’s not a good idea for someone with uncontrolled diabetes, autoimmune or bleeding disorders.
In terms of age, alarplasty is typically performed on adults whose nasal anatomy has fully developed. This usually occurs by age 16-18, though individual factors may influence the timing of surgery. There is no upper age limit for nostril reshaping, as long as the patient is healthy enough to undergo the procedure and has good skin elasticity to support the healing process.
It’s important for a potential patient to understand that while nostril reduction surgery can refine the shape and size of the alar base, it will not address other concerns like a crooked septum, dorsal hump or bulbous tip. These issues may require a more comprehensive rhinoplasty procedure to achieve the desired results.
80% of all patients have noticeable asymmetry in size, shape and contour of the nostrils, and only about 5% of those patients will want to correct it. It’s imperative for your surgeon to point out your nostril asymmetry pre-op so you know that your rhinoplasty surgery is not the cause of asymmetry.
Dr. Younger carefully screens all potential candidates to ensure they are medically and psychologically prepared for the procedure and have a positive outlook on the expected outcome.
Alarplasty Techniques
There are several alarplasty techniques that can be used to refine the size and shape of the nostrils, depending on the patient’s specific concerns and anatomy. Dr. Younger is skilled in all of these approaches and will select the method that can achieve the most natural-looking, symmetrical results in each case.
Regardless of the specific approach, Dr. Younger takes great care to preserve the natural shape and function of the nostrils while achieving the desired aesthetic improvements. He uses delicate instruments and meticulous suturing techniques to minimize tissue trauma and promote optimal healing.
Alar Wedge Excision
The alar wedge technique involves removing a small, triangular wedge of tissue from the base of each nostril where it meets the cheek. This is an effective way to reduce nostril flaring and create a more streamlined alar contour. The incisions are placed in the natural creases of the nostrils, so the resulting scars are well-concealed.
Wedge excisions are best suited for patients with a wide alar base and noticeable flaring, especially when smiling or laughing. They can also help correct hanging columella (the strip of tissue between the nostrils) by lifting and supporting the nasal tip. The downside of this technique is that it does not address nostril width or elongation, so it may need to be combined with other methods for more comprehensive reshaping.
Weir Excision
The Weir technique is a modified version of the wedge excision that follows the natural curve of the alar crease. It allows for a greater degree of tissue removal and more precise reshaping of the nostril contours. Like wedge excisions, Weir excisions are primarily used to address alar flaring and create a more triangular nostril shape.
One advantage of the Weir technique is that it can be customized to remove more tissue from the top or bottom of the wedge, depending on whether the goal is to shorten the nostril length or narrow the alar width. It also allows for more control over the final nostril shape and size, as the incisions can be adjusted to create a more angular or rounded appearance.
Combinations
In some cases, Dr. Younger may use a combination of these techniques to achieve the desired nostril proportions. For example, he may perform a sill excision to reduce nostril width, followed by a Weir excision to refine the alar contours and address any remaining flaring.
What to Expect
Consultation
The first step in considering alarplasty is to schedule a consultation with Dr. Younger at his Vancouver office. During this in-depth meeting, he will take the time to listen to your concerns, assess your nostril anatomy and determine if you are a good candidate for the procedure. He will ask about your medical history, including any previous nasal surgeries, allergies, medications and smoking status to identify any potential risk factors or contraindications.
Next, he will perform a thorough physical examination of your nose, paying close attention to the size, shape and symmetry of your nostrils. This may involve taking measurements, photographs and using specialized tools to analyze the proportions of your nasal anatomy. Dr. Younger will also assess the quality and thickness of your nasal skin, as this can influence the surgical approach and final results.
Based on his evaluation, Dr. Younger will explain whether alarplasty, rhinoplasty or a combination of the two would best address your concerns. He will walk you through the recommended procedure step-by-step, including the type of anesthesia, incision placement, amount of tissue removal and expected recovery timeline.
Using state-of-the-art imaging technology, Dr. Younger can manipulate your photographs to generate a simulated preview of your potential results. This helps patients visualize the subtle yet significant changes that nostril reshaping can achieve and ensures that everyone is on the same page regarding the aesthetic goals.
The consultation is also an opportunity for you to ask any questions you may have about Dr. Younger’s background, alarplasty techniques or the surgical experience. His goal is to educate you fully so that you can make an informed decision about whether to proceed with treatment.
Surgery
Alarplasty is less invasive than a full rhinoplasty. As a standalone procedure, it is usually performed under local anesthesia and takes less than an hour to complete. If combined with other facial procedures, general or local anesthesia may be used, depending on your preferences and the extent of correction needed. Dr. Younger will review the details of your surgery before proceeding so you feel comfortable moving forward.
During surgery, Dr. Younger will carefully mark and measure the base of the nose to determine how much tissue should be removed from each nostril. Then, a small incision will be made, and a sufficient amount of cartilage will be carved out to sculpt narrower, more balanced nasal contours. Once this has been accomplished, the incisions will be closed with sutures that help stabilize the alae’s new outline, or the nostrils’ wings.
Afterward, you’ll be able to return home to begin the recovery process. There’s usually less downtime compared to more invasive procedures, but you can expect typical side effects such as redness or swelling that will persist until the nose begins to heal.
Recovery & Results
Most patients take a week of social downtime following their alarplasty procedure. Mild redness and swelling are more apparent during this time but will gradually subside in the next week or two. Stitches are typically removed after five to seven days at a follow-up appointment, where Dr. Younger will check to make sure the nose is healing properly.
The full recovery process can last for up to three weeks, but most patients feel ready to return to work and other daily activities sooner than this. Strenuous exercise may be restricted for a short time to avoid injuring or straining the new nostril structure.
Results are immediately visible following surgery but will fully develop as post-operative swelling continues to recede. Depending on how much tissue was removed, the nostrils will appear slimmer, narrower and more aligned with the rest of the face. Alarplasty won’t affect the bridge or other features of the nose, but can deliver dramatic results for patients who feel their nostrils are disproportionately wide and detract from their overall appearance.
Combining Alarplasty with Rhinoplasty
While alarplasty can be a highly effective standalone procedure for refining the nostril shape and size, it is often performed in conjunction with rhinoplasty for more comprehensive nasal reshaping. Rhinoplasty is a surgical procedure that addresses the overall size, shape and proportions of the nose, including the bridge, tip and nostrils.
There are several scenarios where combining alarplasty with rhinoplasty may be recommended:
- When the nostrils are disproportionately wide or flared in relation to a large or prominent nasal tip
- When nostril asymmetry is accompanied by a crooked or deviated septum
- When the nose is being reduced in size and the nostrils need to be adjusted to maintain proper proportions
- When a previous rhinoplasty has left the nostrils too wide or asymmetrical
By addressing multiple concerns in a single surgery, patients can achieve more balanced, harmonious results and avoid the need for separate recovery periods. Dr. Younger can create a customized treatment plan that targets each individual’s specific goals and anatomical needs.
One advantage of combining alarplasty with rhinoplasty is that Dr. Younger can adjust the nostril reshaping to complement the changes made to other parts of the nose. For example, if the nasal tip has been lifted and projected, he may remove slightly more tissue from the nostril base to maintain a balanced, cohesive appearance. Conversely, if the nose has been significantly reduced in size, he may be more conservative with nostril reduction to avoid an overly pinched or constricted look.
In terms of recovery, the timeline for a combined procedure may be slightly longer than for alarplasty alone, but still shorter than undergoing two separate surgeries. Most patients can expect to take 7-10 days off from work and other normal activities, with more strenuous exercise restricted for several weeks. Swelling and bruising may be more noticeable initially but should subside within a similar timeframe as an isolated alarplasty.
The final results of a combined rhinoplasty and alarplasty procedure can be incredibly transformative, bringing the entire nose into better harmony with the rest of the facial features. By addressing both the overall nasal structure and the specific concerns of the nostrils, Dr. Younger can help patients achieve their ideal aesthetic outcome and enjoy a greater sense of self-confidence in their appearance.
Schedule Your Alarplasty Consultation
Dr. Ritchie Younger is one of Canada’s leading facial plastic surgeons, with decades of experience in helping patients bring the nose into harmony with their natural features. If you’re unhappy with the size or width of your nostrils and want to learn more about alarplasty, contact or call the Younger Facial Surgery Centre in Vancouver today at 604-670-0510.
As Vancouver’s leading facial plastic surgery expert, Dr. Younger has been expertly helping thousands of happy patients look their best. Book a consultation to see what he can do for you.