An alar base is imperative in appraising the overall appearance as well as proportion of a person’s nose. A flared or overly wide alar base may result in a heavy bottom nose and hence disrupt the subtle balance between the different features of a person’s face. This is commonly observed in people of following origins:
Often, a rhinoplasty surgeon may suggest alar base resection. For this, prudent care should be taken to assess whether the excessive width results from excessive soft tissue, large nostrils or wide alar base. From there, an appropriate design is used for alar base reduction. Nostril reduction without due consideration of its secondary effects can often cause the nose to look excessively “pinched”, the tip to look paradoxically bigger and the paranasal depression to appear worse.
The nasal ala composed of soft tissues at the nostril rim and cartilage at the upper nostril. An alar base joins the upper lip area with the cheek. The shape, width, and overall size of this area are primarily the cosmetic concern of nose plastic surgeons. One of the common concerns of the patients seeking rhinoplasty is their wide/flaring nose. In order to bring greater harmony to their face, many patients opt for nostril narrowing or alar base reduction option.
Due to complexity and variability involved in the alar base structure, there are unique challenges associated with the alar base surgery. In the course of a surgical evaluation, the top rhinoplasty surgeons evaluate alar base in terms of the nostril symmetry, size, and shape. Other factors may include the thickness of the nose skin, amount of alar base modification required, and its exact shape and location.
Fundamentally, two most widely used techniques in alar base reduction are:
Weir Incisions: This is the standard surgical techniques used by best rhinoplasty surgeon in the world for alar base reduction. This technique encompasses the removal of a small tissue from the nostril’s edge, i.e., the point wherein the nostril connects the cheek. Subsequently, the nostril is pulled down and then re-attached. This surgical procedure is normally used for rounding of the nostrils or removing the nostril flare.
Joseph Incisions: This is another surgical procedure that takes into account the removal of tissue located at the base of a nose, known as the nasal sill (situated between the edge of the nostril and columella). This procedure is recommended for reducing the overall width of the nostril.
Post an alar base reduction, a surgeon accurately rounds the ala to give the patient’s nose an appropriate shape. If the surgery is incorrectly done or the tissue is removed in an over aggressive way, a patient may lose the natural nostril curve along with abnormal scars at the nostril area.
To avert this outcome, Dr. Tan Kar Su makes use of specialized surgical techniques and procedures to maximize the odds for a natural and smooth nostril contour, without any discernible scar. Besides, the doctor also takes care of:
The key objective of an alar/large nostrils reduction procedure is to provide a natural and well-proportioned outcome to the patient, without any secondary distortion.