Is Alar Reduction a Surgery You Should Avoid? The Real Reasons It Can Look Unnatural and the Key Points

“I’ve heard people say that if you’re considering alar reduction, you shouldn’t have it done. Is it really okay?”

“What if my nostrils become narrower but my nose ends up looking awkward instead?”

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Alar reduction is one of the questions we receive most often in our consultation room.

Even with a quick search online, some people say, “Alar reduction is a surgery you shouldn’t have,” while others say, “It’s an excellent procedure when performed appropriately.” It’s only natural to feel confused.

Let me start with the conclusion:

Alar reduction is absolutely not a surgery that everyone should avoid.

However, it can easily look unnatural if several important points are not observed, so today I’ll explain the reasons one by one.

Why do people say that alar reduction is “a surgery you shouldn’t have”?

Alar reduction is a surgery that naturally narrows the nostrils of people whose alar width appears broad when viewed from below or from the front.

Simply put, it involves partially excising the laterally flared nostril wings to reduce their appearance. The most important point here is that the nasal alae have a normal structure that must be preserved.

Because this is a surgery in which that structure must not be damaged, if that area is compromised, people may even begin saying that “alar reduction is a surgery you shouldn’t have.”

Diagram comparing wide nostril wings and natural nostril wings / Key points of alar reduction, alar reduction scars, and alar reduction surgery

The real reason it can look unnatural ①: Scars and “angles”

The first concern people have with alar reduction is scarring.

Since scars cannot be eliminated completely, the key is to make them less noticeable.

That is why a commonly chosen approach is to conceal the scar along the crease where the nostril wing meets the face.

It may seem that “if the incision is made exactly along this crease, the scar will be difficult to see,” which can lead to excessive excision in this area.

The problem is that the tissue is not merely cut; after the surgery, it must also be sutured back together.

During the healing process, there is a fairly high possibility that the natural angle that was originally present will be disrupted.

The reason the nostrils may be narrower but still look somehow awkward or unattractive is, in many cases, precisely this.

The real reason it can look unnatural ②: A structure that makes revision difficult

Some people are disappointed with the awkward appearance of their nose and consider revision surgery.

However, if the scar is positioned exactly along the boundary between the nostril wing and the face, removing that scar cleanly during revision can be extremely difficult.

To remove the scar, it may become necessary to excise additional skin from the base of the face.

For this reason, we do not recommend aggressively excising this normal boundary structure. We believe the procedure should be performed while preserving as much of the naturally occurring normal tissue as possible.

Once it is cut, it is difficult to reverse

There is another reason many doctors discuss alar reduction cautiously.

Alar reduction involves removing part of the normal tissue, so once it has been excised, reversing the procedure is not easy.

The removed tissue cannot simply be reattached.

That is why it is especially important to take a conservative approach rather than overcorrecting out of a desire for a dramatic change.

If the reduction is slightly insufficient, it is possible to narrow the nostrils further later. However, reversing an overly aggressive reduction is much more difficult.

So, what is the key to natural-looking alar reduction?

In summary, satisfaction with alar reduction tends to be higher when the following principles are observed.

• Preserve the normal structure of the boundary between the nostril wing and the face

• Design the procedure so that the natural angle of the nostril wing is not disrupted

• Take a conservative approach, since the procedure is difficult to reverse

The three key points for natural-looking alar reduction, alar reduction scars, and alar reduction surgery

If these points are carefully observed, alar reduction can be a highly effective procedure with a high level of satisfaction for people who are concerned about wide nostril wings.

We recommend a consultation if you:

• Feel that your front or side profile looks heavy or constricted because your nostril wings appear wide

• Are concerned about scarring after alar reduction

• Previously underwent alar reduction, but are considering revision because the result looks awkward

• Want to narrow your nostril wings naturally, without an obvious appearance of surgery

Frequently Asked Questions (FAQ)

Q. Is alar reduction a surgery that should be avoided?

A. No. When the normal structure of the boundary is preserved and the procedure is performed conservatively so that the angle is not disrupted, it can be a highly satisfying surgery.

However, excessive excision can make the result look awkward, so choosing the right approach is important.

Q. Will alar reduction scars be very noticeable?

A. Scars cannot be eliminated completely, but careful management of the location and suturing can make them less noticeable.

However, as mentioned above, excessively excising the boundary can instead disrupt the angle and make the result look unnatural.

Q. My nose looks awkward after alar reduction. Is revision surgery possible?

A. It is possible, but removing the scar can be complicated if it is located along the boundary.

That is why preserving the normal tissue during the initial surgery is especially important.

Q. How much should the nostril wings be reduced?

A. Since the procedure is difficult to reverse, it is better to take a conservative approach.

Additional correction is possible if the reduction is insufficient, but restoration is difficult if the nostril wings are reduced excessively.

We recommend deciding whether to proceed with surgery only after receiving an accurate diagnosis and having a thorough consultation with a specialist.

In summary,

Alar reduction is not “a surgery you shouldn’t have”; it is a surgery in which the result depends on how it is performed.

By preserving the normal structure of the boundary between the nostril wings and the face, maintaining the natural angle, and taking a conservative approach, it can be a suitable option for people concerned about wide nostril wings.

However, nasal structures vary from person to person, so rather than making the decision on your own, we recommend deciding only after receiving an accurate diagnosis and having a thorough consultation with a specialist.

Reference video:

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This content was written directly by MOOi Plastic Surgery Clinic for informational purposes, to make information about procedures and surgery easier to understand, in compliance with Article 56, Paragraph 1 of the Medical Service Act. As every procedure and surgery may involve individual differences and side effects, we strongly recommend consulting with your medical provider before proceeding.