Reducing the Nostrils (Alar Base Resection) and Enlarging the Nostrils With a Small Amount of Filler in 5 Minutes in Office Conditions

Very Small Touches to The Tip of The Nose in Office Conditions Instead of Revision Nose Aesthetics

A patient who had undergone rhinoplasty in a different clinic due to severe asymmetrical nasal deformity applied to our clinic because of asymmetry in the nostrils. Since the patient did not want another complicated nose operation, we planned to perform a few "small, minimally traumatic" procedures in office conditions. We determined that the right nostril of the patient was larger, since the base of the patient's right nostril was wider than the left. We found that there was a limited amount of pitting due to collapse at the incision site in the upper left corner of the left wing. We performed alar base resection for the right nostril under local anesthesia and a limited amount of filler injection to the upper corner of the left nostril. It may be necessary to repeat the self-absorbable nasal filling, but the asymmetry between the nostrils was reduced as much as possible without the patient's general anesthesia and without a serious surgical trauma.

Alar Base Resection, Nose Filler Injection To The Nose Tip, Nostril Asymmetry, Revision Nose Tip Aesthetic
Right Alar Base Resection + Limited Amount of Filler Injection to Left Nose Wing
In the photo above, the patient's right nostril is larger and there is a small amount of collapse in the upper part of the left nasal wing. This usually occurs as a result of collapse or fibrotic development in the hidden incision just below the left nasal wing. The width at the bottom of the right nostril was greater than the left, and it was aimed to shorten this distance and make it as close to the left nostril as possible. In other words, it was aimed to narrow the base of the right nostril and slightly expand the upper part of the wing in the left nostril.

Photo and Process Description:

- In the photo above, the base of the right nostril (red double-headed arrow line) appears to be wider than the left
- After local anesthetic cream application and local anesthetic injection, right alar base resection was performed. During the procedure, tissue was removed from the medial side, close to the base of the nostril. It was sutured with self-absorbable suture materials (yellow arrow in bottom photo).
- After alar base resection, narrowing at the base of the right nostril is visible (red double-headed arrow line in the bottom photo)
- In order to partially enlarge the left nostril, a limited amount of hyaluronic acid filler was injected into the upper-outer part of the nasal wing (green arrow in the bottom photo). When you look at the top and bottom photos on the same street, it can be noticed that the left nostril is smaller in the top photo and the incision site is seen just close to the nose wing, and the left nostril is larger in the bottom photo, and the incision site is no longer visible.

No nasal bandage or nasal packing was used after the procedure. The process was terminated in about 5 minutes.

Two Frequently Used Alar Base Resection Techniques

Two Frequently Used Alar Base Resection Techniques  ((Apart From These Incisions, There Are Also Modified Techniques and Different Alar Base Resection Techniques!))
Two Frequently Used Alar Base Resection Techniques 
(Apart From These Incisions, There Are Also Modified Techniques and Different Alar Base Resection Techniques!)

In the photo above, two different alar base resection techniques that are frequently used are shown. In the technique number 1 shown in the image here, the triangular tissue (yellow triangle) is removed from just below and inside the nostrils, and the incision sites are approximated, and the nostrils are reduced by stitching them together. It is an alar vase resection technique with only a limited amount of nostril reduction, with little visible scarring, as in our patient in the top photo. In image number two, it is an alar base resection technique that includes tissue removal (dark areas), which can be extended to the outside of the nose wing, which is preferred especially in patients with wide and flat nasal wings and wide and flattened nostrils.

Dr.Murat Enoz is taking about alar base resection and alarplasty

In addition to the alar base resection techniques that I have shared with you here, there are also modified alar base resection techniques that include different vertical and bed tissue removal. There are also techniques where these can be done together at the same time. You can take a look at valuable scientific articles published by different physicians on this subject >> Nasal base narrowing: the combined alar base excision technique / Excessive Alar Base Resection in Rhinoplasty: How to Deal With It Once Recognized Intraoperatively?

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

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