How to Reduce Wide Nostrils

Dec 14, 2021 Source: Cainiu Health

Dr. Xu Gang

Introduction

When the alae are not excessively wide, a columellar strut graft can be inserted, and cartilage grafting can be performed at the nasal tip. This will elevate the nasal tip and consequently reduce the width of the alae—no additional surgical procedures are required. Therefore, the need for alar reduction must be assessed and determined only after the nasal tip elevation procedure has been performed.

The alae (nostril wings) significantly influence the overall nasal appearance. Many individuals perceive their entire nose as unattractive solely due to poorly shaped alae. Since nasal aesthetics greatly impact facial harmony, numerous people opt for alar reshaping procedures—such as alar reduction surgery—for those with overly broad alae. Below, we outline the ideal candidates for alar reduction surgery and describe the specific surgical techniques involved. Details follow:

How to Reduce Broad Alae

Mild Alar Broadening

In cases of mild alar broadening, an alar strut graft may be inserted into the columella, combined with a nasal tip cartilage graft. This elevates and projects the nasal tip, thereby creating the visual effect of narrower alae—without requiring additional surgical intervention on the alae themselves. Therefore, the necessity of alar reduction must be assessed only after completing nasal tip projection surgery.

Broad Alae Accompanied by Wide Nostrils

For patients presenting both broad alae and wide nostrils, careful partial resection of the alar base combined with nostril narrowing is recommended. Incisions are planned along the alar base and inferiorly within the alar groove. Under local anesthesia, a portion of the full-thickness alar base tissue is excised, followed by medial rotation and advancement to reduce nostril width. Layered interrupted sutures are then applied. Postoperative scars typically measure no more than 1 cm in length.

Narrow Nostrils with Thick Alae or Excess Fullness in the Superior Alar Groove

A skin incision is made along the anterior border of the lateral crura of the alar cartilage at the nostril margin. The skin is then subcutaneously dissected from the underlying alar cartilage. Redundant soft tissue overlying the cartilage is excised, and a portion of the superior and lateral aspects of the alar cartilage is carefully trimmed. Next, via an intranasal approach, a rhomboid-shaped segment of vestibular skin and nasal mucosa is excised from the medial aspect of the alar base, and excess fat is removed. Finally, the incision at the nostril margin is sutured to the incision on the medial surface of the alar base. Postoperative scars generally do not exceed 1 cm in length.

Although alar reduction surgery is considered a relatively minor cosmetic procedure, the nasal region is highly sensitive and anatomically complex—thus demanding exceptional surgical skill and precision. It is therefore essential to select a qualified, experienced surgeon to perform the operation.

We hope this information has been helpful. Wishing you a happy and fulfilling life!

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