Who is suitable for alar reduction:
1. For individuals with relatively wide alar margins, a portion of the free edge of the alar can be partially excised. After reshaping, the incision is sutured to the inner surface of the alar.
2. Alar reduction through excision is typically suitable for African Americans and Asians, serving as a method to narrow the alar when the nasal base is too wide or the nostrils are excessively large.For individuals with excessively wide alae primarily due to surplus skin, excising the lower alar skin and suturing the incision can reduce alar width while elongating the appearance of the nostrils. This technique places the incision along the alar-cheek junction, minimizing visible scarring.
3. For individuals with both wide alae and nostrils, a cautious approach to alar base reduction and nostril reduction surgery is often feasible. Typically, the surgeon designs an incision at the alar base and lower alar sulcus. Under local anesthesia, a portion of the full-thickness tissue at the alar base is appropriately excised. This is followed by internal rotation and advancement to narrow the nostrils, secured with layered interrupted sutures.Post-operative visible scars will not exceed 1 cm in length.
4. When the alar base is not excessively wide, inserting an auxiliary column into the columella combined with tip cartilage grafting can achieve elevation. This naturally reduces alar projection without requiring additional procedures. Therefore, the necessity for alar reduction must be evaluated post-operatively after tip elevation surgery.