Alarplasty (Narrowing Wide Nostrils): Before and After, Recovery, and Cost

nose surgery alarplasty
  • Alarplasty is a specialized cosmetic surgery that reduces the width of the nostrils.
  • It’s not to be mistaken for rhinoplasty, which alters the underlying structures of the nose.
  • Not all plastic surgeons are qualified to perform this procedure.

What is an alarplasty?

An alarplasty adjusts the size and shape of the nostrils by removing a predetermined amount of soft tissue. It involves the alar region of the nose — the flexible, soft tissue that extends outward from the nasal tip to the face. Above the alar region lies the area popular for nose piercings, and just outside of there is the alar crease. Looking up at the nostrils, one can see the alar base which makes up the width from the right alar to the left alar. Alarplasty augments or reduces this part of the nose.

How is an alarplasty performed?

To perform an alarplasty, a plastic surgeon gives the patient local anesthesia, makes an incision either outside or inside the right and left alar regions, and then removes a section of tissue from each side. Finally, the surgeon closes the incisions with sutures. No changes are made to the bone or cartilage, so the underlying structure of the nose is not affected. It’s only the nasal flare that changes.

The procedure usually takes between 45 minutes to one hour, excluding the time needed for local anesthesia to take effect. Thanks to the anesthesia, the procedure is painless, and post-surgical scars are well-hidden because all incisions are made in the alar crease.

Alarplasty B&A
Alarplasty before and after credit: Portland Facial

Recovery and results

In most cases, patients need one to two weeks for recovery, as there may be some minor bleeding, pain, swelling, and discomfort. Gently applying a cold pack to the area can help with swelling, and your surgeon will likely prescribe a mild painkiller to be used as needed.

At least two follow-up visits will be necessary to first remove the bandages and later the stitches. After follow-up appointments, continue to avoid strenuous activity because the ala will still be healing.

Here are some additional tips for post-surgery care:

  • Avoid tobacco and alcohol for at least 5 days after surgery.
  • Sleep face up with your head elevated by extra pillows, between 45 to 90 degrees.
  • Use a Q-tip moistened with clean water or saline to clean the area around your nose and inside your nostrils.

How much does an alarplasty cost?

The cost of alarplasty surgery is $6,000 – $7,000.

Alarplasty vs. rhinoplasty: what’s the difference?

“Alarplasty is very common, particularly among patients that are undergoing rhinoplasty surgery,” says New York City-based plastic surgeon Dr. Philip Miller. “This is because a patient seeking to alter the bone or cartilage in their nose will often request that adjustments be made to their nostrils as well.”

Cosmetic rhinoplasty is a procedure that modifies the appearance of the nose. There are more specific types of rhinoplasty, however, depending on the modification desired:

  • Reduction rhinoplasty aims to decrease the size of the nose by modifying the nasal tip and nasal bridge, sometimes called the dorsal hump.
  • Augmentation rhinoplasty increases the size of the nose by replacing missing or underdeveloped cartilage.
  • Revision rhinoplasty usually corrects complications arising from prior procedures, and restores anatomical structures that may have been compromised.
  • Post-traumatic rhinoplasty repairs the nose, restoring its original shape and appearance after an injury; many patients seize this opportunity to make additional changes they may have sought in cosmetic rhinoplasty.
  • Turbinate reduction involves small sections of tissue inside the nose that cleanse and humidify inhaled air before it enters the lungs; this tissue, called turbinates, can become inflamed by allergies, infection, or other means and generate mucus, making breathing difficult.
  • Septoplasty corrects deviations of the septum, which is the cartilage and bone that separate the nostrils and the nasal cavity; airflow can be obstructed by deviated septa, which are often the result of a birth defect or trauma to the nose.
  • Rhinoseptoplasty is needed when septal deviations are too complex for regular septoplasty or when there is an additional deformity on the external portion of the nose.

“While rhinoplasty is one of the most frequently performed cosmetic procedures, alarplasty is not as common as a stand-alone procedure,” says Boca Raton, FL plastic surgeon Dr. Jacob D. Steiger. “Generally, an alarplasty is performed at the same time as a rhinoplasty, because altering any part of your nose will affect the harmony with the other parts.”

How do you choose the right surgeon?

Plastic surgery refers to medical procedures that repair physical defects by reconstructing the body’s physical appearance or restoring its normal functioning. According to the American Board of Cosmetic Surgery (ABCS), alarplasty may not be considered plastic surgery but rather cosmetic surgery because it’s primarily focused on enhancing physical appearance.

Though cosmetic surgery and plastic surgery are closely related, surgeons in each field are trained differently. Naturally, cosmetic surgeries — like tummy tucks, breast surgery, face surgery, and liposuction — are the domain of cosmetic surgeons, but these sorts of procedures make up only one-sixth of the standard training for plastic surgeons. Following residency, many plastic surgeons undergo extra training in cosmetic procedures to receive board certification.

When it comes to selecting a surgeon for alarplasty, you may find plastic surgeons who claim to specialize in a particular procedure or in cosmetic procedures in general. It’s essential that you research the surgeon’s background, medical training, and, if possible, examine before and after pictures of their previous patients.

Dr. Steiger advises that “Plastic surgeons who specialize and frequently perform rhinoplasty, are best to perform alarplasty surgery.”

» For more information on alarplasty, meet our Medical Review Team.

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