Alar Base Reduction London

Alar base reduction, also called nostril narrowing, nostril reduction, or alarplasty, is a surgical procedure to reduce the width of your nostrils or correct nostril flare. The “alar base” refers to the curved outer wall of each nostril where it meets the cheek.

It's one of the most subtle yet effective procedures in facial plastic surgery. A few millimetres of change at the nostril base can significantly refine the overall appearance of your nose, particularly from the front view. It can be performed as a standalone procedure (under local anaesthesia, taking 30 to 45 minutes) or as part of a larger rhinoplasty.

The procedure is particularly common in patients of Afro-Caribbean, South Asian, and East Asian heritage, where a wider alar base is a natural ethnic feature. But it's not exclusive to any group: patients of all backgrounds seek nostril narrowing.

There's an important difference between nostril flare and nostril width, and the surgical technique differs for each.

Nostril flare

This is when the outer curve of the nostril (the alar rim) extends outward beyond the base. When you look from the front, the nostrils appear to bow outward. Correcting flare involves removing a wedge of tissue from the alar sidewall, the curved part of the nostril. The scar is hidden in the natural crease where the nostril meets the cheek.

Nostril width

This is when the base of the nostrils is wide, even if they don't flare. The distance between the outermost points of your nostrils exceeds the ideal proportion (roughly the distance between your inner eye corners). Correcting width involves removing a wedge from the nostril sill, the floor of the nostril where it meets the upper lip.

Combined

Many patients have both flare and width. In these cases, I address both with a combined technique that removes tissue from both the alar sidewall and the sill. The amount removed at each site is calibrated independently based on how much flare and how much width needs correcting.

Alar base reduction is one of the procedures where less is almost always more. Over-resection is very difficult to reverse, because you cannot add tissue back to the nostril base in a way that looks natural. This is why I approach every case conservatively, removing the minimum amount of tissue needed to achieve the desired change.

At consultation, I use measurements and proportional analysis to determine exactly how many millimetres of reduction are appropriate. The aesthetic guideline is that nostril width should approximately equal the intercanthal distance (the gap between your inner eye corners), but this is a guide rather than a rule. Your face is unique, and the right amount of narrowing depends on your overall facial proportions.

I also consider your ethnicity and aesthetic goals carefully. For some patients, a degree of alar flare is a natural and desirable part of their appearance. The goal is always refinement that you're happy with, not conformity to a single standard.

The most common concern patients have about alar base reduction is scarring. This is a legitimate concern, and technique matters enormously here.

When performed correctly, the incisions are placed in the natural alar crease, the fold where the nostril meets the cheek. This is a natural shadow line on the face, which means scars heal virtually invisibly in the vast majority of patients. At one year, most patients cannot identify their scars even when looking closely in a mirror.

Factors that affect scarring include skin type (darker skin has a higher risk of hypertrophic scarring or hyperpigmentation), surgical technique (tension-free closure is essential), and aftercare. I use fine absorbable sutures and give detailed scar care instructions for the first three months after surgery.

For patients with a history of poor scarring or keloid formation, I discuss this risk explicitly at consultation. In some cases, a small test area may be advisable before committing to the full procedure.

Alar base reduction can be performed entirely on its own. As a standalone procedure, it takes 30 to 45 minutes under local anaesthesia in the clinic. There is no splint, no bruising around the eyes, and minimal downtime. Most patients return to work the next day with small steri-strips over the incision sites.

However, most patients who are bothered by wide nostrils also have other nasal concerns: a wide tip, a dorsal hump, or asymmetry. In these cases, alar base reduction is performed as the final step of a comprehensive rhinoplasty, under general anaesthesia, as part of a single procedure. This means one recovery period rather than two.

Importantly, if you're having a full rhinoplasty, the alar base reduction is done at the very end of the procedure, after all other work is complete. This is because tip refinement and osteotomies can change the nostril shape and width, so the surgeon needs to see the final result before deciding how much (if any) alar base reduction is needed.

As a standalone procedure, recovery is straightforward. Small steri-strips or dressings are worn over the incision sites for five to seven days. There is mild swelling around the nostrils that resolves within one to two weeks. Bruising is minimal or absent because no bone work is involved.

Sutures are typically dissolvable and do not need to be removed. You can wash your face normally from day 2. Most patients return to work and social activities within two to three days.

The scars go through a maturation process over three to six months. They may appear pink or slightly raised initially, then fade to match your skin tone. Sun protection during the first three months is important to prevent hyperpigmentation.

If performed as part of a full rhinoplasty, the recovery timeline follows the rhinoplasty recovery schedule: one week in a splint, two weeks of visible swelling, and gradual refinement over 12 to 18 months.