Under normal circumstances, the outermost edge of the nostrils should not extend beyond the vertical line of the inner canthus; otherwise, it indicates enlarged nostrils.Wide alae make nostrils appear large. Even if the nasal bridge isn't low, wide alae can make the nose appear low, giving a somewhat blunt, lackluster impression that doesn't create a favorable appearance. For a low nose with slightly wide alae, rhinoplasty alone can achieve alar reduction. However, individuals with very wide alae require alarplasty to reduce the overall nasal size and achieve a more refined, mature appearance. Alarplasty must adhere to the following surgical principles.
1. Prior to surgery, routine coagulation function tests should be conducted. For deformities caused by underlying diseases, the disease must be treated first to eliminate the cause. Local nasal infections should also be treated beforehand.
2. Surgery is best performed after the patient reaches adulthood. Repairing too early may result in the nose becoming deformed again after facial development.
3. In cases of severe nasal collapse with upward retraction of skin and soft tissue, staged surgery is essential. First, the nasal structure is dissected and repositioned to a normal position, followed by implant placement.
4. Strict aseptic technique is mandatory during surgery. Infection may cause implant necrosis and expulsion.
5. Before implanting the filler, pay attention to the separation layers, cavity size, and symmetry. The resulting cavity should be suitable for the filler placement—neither too tight nor too loose.
6. Based on the shape and size of the depressed areas (such as the nasal bridge), insert an appropriate filler. Then suture the wound and fix the external nasal shape. Postoperative penicillin injections are recommended to prevent infection.
Editor's Note: While alar reduction surgery offers a solution for those seeking to refine a wide nose, compromising normal nasal function would render the outcome counterproductive. Therefore, strict adherence to surgical principles is essential. Additionally, minors should ideally postpone this procedure until adulthood.