Alarplasty (Nasal Base Surgery)

By Dr Leow Aik Ming

Nasal base varies with one’s ethnicity. Wide flaring nostril and large nostril openings are very common among the Africans, Asians and occasionally in Caucasians. In general, the width of the eye or the area between the eyes comprises about one-fifth of the facial width. On a frontal view, a wide nasal base may distract the apparent facial balance or distract the surrounding facial features.

The shape of the nose base, when viewed from below, is generally triangular in shape. The shape of the outer nostril wall (nasal alar) ideally displays a gentle convexity between the nasal tip and nose-cheek junction (alar crease). When the shape of the nasal alar demonstrates an accentuated convexity, this may detract from nasal or facial balance.

Alarplasty is a cosmetic surgical procedure aimed to reduce the wide flaring nostrils and nasal base width by removing a wedge of the nose at the alar base. The wound is closed together by meticulous repositioning at the natural crease of the external nose-cheek junction or hidden in the nostril to conceal the tell-tale sign of surgery. This surgery can be done alone or combination with nasal augmentation to enhance the overall appearance (size, shape, symmetry and proportion) of the nose and nostrils.

Preoperative evaluation before alarplasty

During the pre-operative consultation, a detailed examination and analysis of the nose and alar is performed. Communication is vital in order to achieve the patient’s goals. During the initial consultation, patients should discuss their goals and expectations with the plastic surgeon. The plastic surgeon will work closely with the patients to reach an agreement about the desirable results from the surgical procedures involved and their long term benefits.  Every patient is different. Therefore, a comprehensive surgical plan is customized to address each patient’s cosmetic and functional concerns which include:

  • Discussion about expectation and desired outcome
  • Medical conditions, drug allergies and previous medical or surgical treatment
  • Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs should be revealed
  • Discussion of type of anaesthesia
  • Examination of the nose and face
  • Photography for preoperative and postoperative evaluation.

Postoperative expectations

Post surgical swelling peaks at about two to three days after surgery and gradually subsides thereafter. Most patients return to work on 1-2 days after surgery. The recovering time from alarplasty usually takes about 7-14 days in most cases for the swelling and bruises to subside. Any external visible sutures are removed one week after surgery. An appreciable improvement in the visible scars at the alar crease or inside the nostrils is evident at one month and will continue to become inconspicuous 6-12 months after surgery. Routine postoperative follow up are periodically scheduled for the year following surgery to ensure optimal healing.

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