Alar Base Reduction

Alar Base Reduction
Treatment of Nostrils That Are Too Wide

The complaint of a nostril that is “too wide” is a problem which we more frequently encounter among many patients, and especially in certain ethnic groups. Alar base (“nostril narrowing”) surgery poses a unique set of difficulties. External incisions can be noticeable, especially if they are designed incorrectly. Most commonly, evidence of alar resection is noted as a teardrop or “Q” deformity in the base of the nostril. In others, the nasal base appears abnormal, as the smooth contour of the nasal sill has been interrupted or because resection has resulted in more marked asymmetry. Moreover, overresection can result in a narrow dysfunctional nostril opening that is difficult, if not impossible, to correct. In other words, when alar base reduction is done incorrectly, a patient can lose the natural curve to the nostril and be left with a very triangular look (think Michael Jackson or Latoya).

Drs. Litner and Solieman employ alar base reductions in the context of an overall surgical plan and normally defer this portion of the case to the end of the surgery. No surgeon can determine preoperatively the exact location, shape, and amount of alar base alteration which is required because nostril size and shape as well as alar base width and flare are all affected by other changes made during rhinoplasty. Specifically, increased tip projection (making the tip bigger), will often sharply reduce the alar flare and alar base width. On the other hand, retrodisplacement of the nasal tip (making the tip smaller) has, at least classically, been noted to create alar flaring as well as a rounded nostril. As such, Drs. Solieman and Litner view alar base surgery as a useful adjunctive measure that they employ to provide an additional measure of refinement. Moreover, their specific techniques, developed over many years, maximize the chances for a smooth, natural nostril contour with no discernible scar.

For more information, please feel free to read our very detailed blog post regarding how we narrow the nostrils