The surgical plan begins with front, base and profile assessment of the nose, nostrils, facial proportions and breathing.
The procedure is indicated for patients whose alar base — the width of the nostrils at their base — is disproportionately wide relative to the rest of the nose or the inter-canthal distance (the distance between the inner corners of the eyes, which is the clinical reference for nasal base width). Specific indications include: nostrils that are excessively wide when viewed from the front; significant flaring when the nostrils visibly widen during normal breathing or expression; asymmetry where one nostril is clearly wider or more flared than the other; or irregularities in nostril contour following previous nasal surgery. In some cases, structural deformity of the alar base may contribute to nasal airflow restriction — this is assessed during consultation.
Alarplasty is performed under local anesthesia, with optional sedation for patients who prefer it. The incisions are placed discreetly — either inside the nasal passages (internal approach) or at the natural crease at the base of the nostril (external approach), where the resulting scar heals inconspicuously within the skin fold. A small wedge or strip of tissue is removed or repositioned to reduce the alar width and correct the contour. The incisions are closed with fine sutures. The procedure typically takes under one hour and is performed on an outpatient basis.
Alarplasty specifically targets the alar base — the width and shape of the nostrils — and does not alter the bridge, tip, dorsum, or internal nasal structures. Rhinoplasty is a broader procedure that addresses the overall nasal structure, including bridge height, tip projection and definition, dorsal hump, and internal deviation. When a patient is satisfied with their nose in general but concerned specifically about nostril width or flare, alarplasty alone may achieve the desired result without full rhinoplasty. When both the overall nose profile and the alar base require correction, the two procedures are performed together in a single operative session.
A flared nose may reflect excessive alar-base width, nostril flare during expression, or both. Alar nose reduction removes or repositions a carefully measured amount of tissue to improve proportion while preserving a natural nostril shape and adequate airway support. The operation is not intended to make every nostril identical; planning respects normal facial asymmetry and individual anatomy.
Alarplasty before and after assessment compares nostril width, flare, symmetry, scar position, and overall facial balance using consistent clinical photographs. Swelling and scar maturation affect early appearances, so final evaluation takes place after healing. Photographs from another patient cannot predict an individual result.
Alarplasty cost depends on the complexity of nostril correction, whether alarplasty surgery is performed alone or with rhinoplasty, anaesthesia, and accredited-facility requirements. The cost of alarplasty is therefore personalised after examination rather than based on a single standard price.
