Incisional or Non-incisional? A Review of Alar Reduction Surgery Cases (Alar Base Reduction)

Hello, I’m Dr. Jo Hyun-woo of the Integrated Plastic Surgery Clinic.

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

It’s alar reduction surgery.

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

There are many different surgical methods, but today I’ll explain them broadly in three categories.

They are lateral-incision alar reduction, medial-incision alar reduction, and non-incisional alar reduction.

� The first, lateral-incision alar reduction, can produce the most dramatic results.

This is a surgical method called 'Weir excision.' As shown in the photo below, it narrows the alar base by partially removing the outward bulging skin on the outer side of the nostril.

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Lateral-incision alar reduction

Many people worry about scarring from the incision site, but because the scar remains in the area where the nose and cheek meet, it is barely visible unless looked at closely, so there’s no need to worry too much.

Many people wonder which method is right for them and whether they need lateral-incision alar reduction.

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Lateral-incision alar reduction

For those whose alar base appears wide, the outer incision method is necessary to narrow the alar base beautifully.

If the procedure is done with a medial incision, only the width of the nostrils is narrowed, which may reduce satisfaction.

Also, for those whose alar base looks bulky, the outer approach can provide sufficient improvement.

I’ll show you before-and-after photos of an actual patient.

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Before-and-after photos of lateral-incision alar reduction

Before-and-after photos of lateral-incision alar reduction

As shown in the photos above, for people with a wide and long alar base, lateral-incision alar reduction can dramatically narrow the alar base and give the tip of the nose a more refined appearance.

Next is medial-incision alar reduction.

Medial-incision alar reduction is suitable for people whose outer alar base is not wide, but who want only the width of the alar base reduced.

It can also be effective when the nostrils appear wide.

As shown in the photo below,

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Medial-incision alar reduction

This procedure involves removing part of the skin from inside the nose and then suturing it closed.

Because the surgery time is short and there is almost no swelling, many people prefer this method.

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

I’ll show you before-and-after photos of an actual patient who underwent medial-incision alar reduction.

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Before-and-after photos of medial-incision alar reduction

As you can see in the photos above, the alar base is naturally reduced, and the nose looks slimmer from the front.

The scar will likely become barely visible over time.

Lastly, there is non-incisional alar reduction.

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Non-incisional alar reduction

This is a method that narrows the width by tying the nasal tip 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.

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In fact, when performing lateral or medial-incision alar reduction, a surgical method called 'Alar Cinching' is used to narrow the alar base further, which is a method of narrowing it with thread.

When an incision is made, the area can be reduced sufficiently and tightened with thread, so a dramatic effect can be achieved. However, if thread-based 'Alar Cinching' is performed alone, the effect is not very large, so I do not recommend it.

So far, we have looked at several different methods of alar reduction surgery.

Because the right surgical method differs from person to person, it is best to receive an in-person consultation and decide on the exact procedure.

There is no single correct surgical method, so considering several options will likely lead to the best results.

Thank you.

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