What’s the Difference Between External Incision, Internal Incision, and Non-Incisional Alar Reduction?

Hello. I’m Dr. Jo Hyun-woo of Inutmed Plastic Surgery.

Today, I’d like to talk about something other than facial contouring surgery.

It is alar reduction surgery.

Alar reduction is often performed together with nose surgery, but many people are also interested in it as a standalone procedure.

There are many different surgical methods.

Today, I’ll explain them broadly in three categories: External incision alar reduction, internal incision alar reduction, and non-incisional alar reduction.

The first, external incision alar reduction, can produce the most dramatic effect.

This is a surgical method called 'Weir excision'.

If you look at the photo below, it narrows the alar by removing part of the protruding skin on the outer side of the nostril.

Many people worry about scars from the incision site, but because the scar remains where the nose and cheek meet, it is hardly noticeable unless you look closely, so there is no need to worry.

Many patients also wonder whether they should have external incision alar reduction and whether it is the right method for them.

For people whose alar appears long, external incision is necessary to reduce the alar nicely.

If internal incision is used instead, only the width of the nostrils may become narrower, which can lead to lower satisfaction.

Also, for people whose alar looks thick, an external incision is needed to achieve enough effect.

Let me show you an actual patient case.

As shown in the photos above, for people with wide and long alar, external incision alar reduction can dramatically narrow the alar and help create a more refined nostril shape.

Next, I’ll explain internal incision alar reduction.

Internal incision alar reduction is suitable for people whose outer alar is not wide, and who only want to narrow the width of the alar.

It is also a procedure that can be effective when the nostrils appear wide.

As you can see in the photo below,

It is a procedure in which part of the skin is removed from inside the nose and then sutured.

Because the surgery time is short and the swelling is not severe, it can be said to be a method that is widely preferred these days.

However, as mentioned earlier, it is not suitable for people whose outer alar is too long or whose nostrils are small.

Then let me show you before-and-after results from an actual patient who underwent internal incision alar reduction.

If you look at the photo above, you can see that the alar has naturally become smaller and the nose looks slimmer from the front.

You can think of the scar as becoming almost invisible over time.

Lastly, non-incisional alar reduction.

At Inutmed Plastic Surgery, we do not perform non-incisional alar reduction surgery, but to explain the principle:

This is a method of narrowing the width by tying the tip of the nose with thread without making an incision.

Because no skin is removed at all, it can sometimes look a little unnatural, and in some cases, the result may gradually return over time.

In fact, when performing external or internal incision alar reduction, a technique called 'Alar Cinching' is used to narrow the alar further, and this is the method of narrowing the alar using thread.

If the alar is sufficiently reduced through an incision and then tightened with thread (Alar Cinching), a dramatic effect can be achieved, but thread alone does not provide a large effect, so I do not recommend it.

So far, we have looked at various surgical methods for alar reduction.

Since there is a surgical method that suits each person, I think it is best to receive a direct consultation and decide on the exact method to apply.

No single surgical method is the only correct answer, so considering several options will likely lead to the best result.

Thank you.