Alar-base-reduction-nostril-reduction
Alar Base Reduction (Alarplasty)
Alar base reduction — sometimes called alarplasty — narrows wide or flared nostrils to bring them into better proportion with the rest of the nose. Scars sit hidden in the natural creases at the base of the nose.
Alar Base Reduction for Refined, Balanced Nostrils
Alar base reduction — also called alarplasty or nostril reduction surgery — is a precise, targeted procedure to narrow the nostrils and refine the base of the nose. It’s ideal for patients who feel their nostrils are too wide, flared, or asymmetrical but are broadly happy with the rest of their nose.
At Centre for Surgery, alarplasty is performed as a day case and takes around 1 hour. Most standalone alarplasties are performed under local anaesthetic with light sedation, so you remain comfortable and go home the same day. Where alarplasty is combined with a full , we use TIVA general anaesthetic for overall comfort.
Because the procedure focuses only on the alar region — the curved base of the nose where the nostrils meet the cheek — recovery is faster than most nose surgery. There’s no work on the nasal bones or bridge, meaning less bruising, no splint, and most patients are back to everyday activities within a week.
The generally accepted aesthetic ideal is that the width of the nostrils should match the distance between the inner corners of the eyes — roughly a fifth of the width of the face. Where the nostrils extend beyond this, the face can feel slightly unbalanced. Alarplasty brings the nostril width into closer proportion without changing the character of the nose itself. It can be performed on its own, combined with , or as a refinement step within full or .
View Our Alar Base Reduction Before & After Photos
A selection of real alarplasty results from our surgeons at Centre for Surgery. A much wider range is available to view at your consultation, and we only publish photos of patients who have given written consent for their images to be used.
Related:
Precise reduction of nostril width through small incisions in the alar crease. The character of the nose is preserved.
Reduction of nostril flare — the lower nose now sits in better proportion with the mouth and cheeks.
Subtle narrowing at the nasal base that balances the overall tip-and-nostril relationship.
Alarplasty combined with tip refinement for a more comprehensive lower-nose change.
What alar base reduction can treat
Alarplasty is a targeted procedure — it addresses concerns confined to the nostrils and alar base. If your issue is specifically nostril width, flare, or asymmetry, and you’re broadly happy with the bridge and tip, this is the right procedure. Below are the concerns we most commonly treat.
Nostrils that appear excessively wide or flare outward are the most common reason patients choose alarplasty. Wide nostrils can make the lower nose look heavier than the rest of the face, particularly on the front view. Precise removal of a small wedge of tissue at the alar base brings the nostrils into better proportion.
Uneven or asymmetrical nostrils — whether congenital, the result of an injury, or following previous surgery — can be rebalanced by adjusting one or both sides. Small adjustments at the alar base have a noticeable effect on how the nose reads from the front and three-quarter views.
In some patients, the lower part of the nose itself is wider than the upper part — the base is broader than the bridge would suggest. A nasal sill excision narrows the base from inside the nostril with no external scar.
Where the columella (the strip of tissue between the nostrils) hangs lower than the nostril edges, it can be corrected through a combination of techniques alongside alarplasty to create a cleaner, straighter profile.
Many patients choose alarplasty to fine-tune a previous or — small, targeted nostril work can deliver a result that full revision surgery would be excessive for.
Alarplasty is often performed as part of a larger nose surgery. Combining it with is particularly common for patients who want to refine the whole lower nose, and it’s a standard refinement step within where nostril width is often part of the concern.
If your concerns extend to the bridge, a dorsal hump, tip projection, or breathing, you’re likely a better candidate for full or . Your surgeon will be honest with you at consultation about what will give you the best overall result.
Am I suitable for alar base reduction?
At your consultation, your surgeon will assess whether alarplasty is the right procedure for you — or whether a full rhinoplasty or combined procedure would serve you better. An honest answer upfront saves you time, money, and disappointment. The main things a surgeon will look at:
Alarplasty is the right choice when your specific concern is nostril width, flare, or asymmetry, and you’re broadly happy with the tip and bridge. If the tip also bothers you, a combined alarplasty-and-tip-rhinoplasty may be more appropriate. If the bridge is a concern too, you’ll likely need full .
You should be — the nose finishes developing around that age, and operating earlier risks the result changing as the face continues to mature. You should be in good general health, at a stable weight, and either a non-smoker or willing to stop for several weeks around surgery. Smoking significantly slows healing and raises the risk of visible scarring at the incision sites.
Alarplasty refines what’s there — it can’t transform the overall shape of the nose. The results are subtle but real: nostrils sit in better proportion with the rest of the face without changing the character of the nose itself. Patients who come in with a specific, grounded goal (narrower nostrils, corrected flare, better symmetry) tend to be much happier than those expecting a dramatic transformation.
Scars sit in the alar crease — the natural fold where the nostril meets the cheek — and fade to become barely visible in most patients. However, patients with darker skin tones or a tendency to form keloid or hypertrophic scars are at higher risk of visible scarring. Your surgeon will factor this into the consultation and discuss realistic expectations honestly.
Alarplasty is very commonly performed as part of — African, Middle Eastern, and South Asian nose shapes more commonly feature wider nostrils as part of the natural anatomy. The surgical approach here is about refinement in a way that preserves the patient’s ethnic features, not erasing them. Our surgeons have significant experience in this area.
We want patients who are having surgery because they want it, not because of pressure from a partner, parent, or social media. If you find yourself fixating intensely on a perceived flaw that others don’t notice, it’s worth reading about before booking a consultation.
Alarplasty isn’t right for everyone. We don’t operate on patients under 18, patients with active sinus or respiratory infections, patients with significant untreated mental health conditions affecting body image, or patients whose concerns extend well beyond the nostrils themselves. For a fuller picture of contraindications, see our article on .
Alarplasty techniques
"Alarplasty" describes a goal — refining the nostrils and alar base — rather than a single technique. Your surgeon will select the right approach based on your specific anatomy, the shape and width of your nostrils, and what you want to achieve. Here are the main techniques used, often in combination.
The alar wedge excision — sometimes called the modified Weir incision — is the most commonly used technique for patients with noticeably flared or wide nostrils. The surgeon makes a precise incision in the natural crease where the nostril meets the cheek, then removes a small wedge of tissue before carefully closing the incision with fine sutures. The scar sits hidden in the alar crease and fades to become barely visible over time.
This approach allows the surgeon to preserve the natural curvature of the nostril, avoiding the over-straightened look that can result from poorly executed alarplasty.
Nasal sill excision is used where the patient has a wide nasal base but not necessarily flared nostrils. The incision is placed inside the nostril, at the sill (the floor of the nostril where it meets the upper lip), with a small amount of tissue removed to narrow the base. Because the incision is internal, there is no external scar.
This technique is often combined with an alar wedge excision when both wide nostrils and a broad base need to be addressed.
V-Y advancement is used to refine the shape of the nostril further, beyond simple narrowing. It involves a second incision placed at the outer edge of the wedge excision, allowing the surgeon to fine-tune the contour and position of the alar rim. This is particularly useful in revision cases or where the nostril shape itself — not just the width — needs adjustment.
Alarplasty is frequently combined with other nose procedures in the same sitting:
Combining procedures in one sitting means one recovery period instead of two, and can be more cost-effective overall.
Preparing for alar base reduction
The weeks before surgery matter more than most patients expect. Healing outcomes are heavily influenced by what you do in the lead-up — the difference between a smooth recovery and a complicated one often comes down to a handful of practical steps. Here’s what we ask our alarplasty patients to do.
Once you’ve decided to proceed, our pre-op assessment team will contact you to confirm you’re medically fit for surgery. This usually involves a review of your medical history and a physical check. If you have any significant health conditions, your surgeon will factor these into the plan or pause surgery until they’re optimally managed.
Smoking is the single biggest driver of wound-healing problems, including visible scarring at the alar incision. Nicotine narrows the small blood vessels that deliver oxygen to healing skin, which can cause poor healing, thickened scars, and — in the worst cases — skin breakdown at the incision. Stop at least six weeks before surgery and don’t start again for four weeks afterwards. Vaping and nicotine replacement products have the same effect and should also be paused. If you need help stopping, the is free and effective.
Stop aspirin, ibuprofen, and other NSAIDs two weeks before surgery — they thin the blood and raise the risk of bleeding and bruising. The same applies to common supplements most people don’t think of as "medications": fish oil, vitamin E, ginkgo biloba, garlic supplements, and St John’s wort. Paracetamol is fine. Flag any prescribed blood thinners to your surgeon as these need careful management with your GP.
Stop drinking for at least a week before surgery and a week afterwards. Alcohol thins the blood, dehydrates you, and interacts with anaesthetic drugs — all of which work against a smooth recovery.
If your procedure is under local anaesthetic only, fasting usually isn’t required — you can eat and drink normally beforehand. If you’re having sedation or a general anaesthetic (typically when alarplasty is combined with full rhinoplasty), no food for 6 hours beforehand and clear water only up to 2 hours before. The admissions team will confirm exact timings when they call to book you in.
Alarplasty recovery is fast compared to full rhinoplasty, but some swelling at the alar base can linger for several months. You’ll see a clear improvement at a week, but the final refinement continues for up to six months as residual swelling resolves.
The alar base reduction procedure
Alarplasty is a day-case procedure — you come in, have surgery, and go home the same day. At Centre for Surgery the operation takes around 1 hour. The anaesthetic used depends on whether you’re having alarplasty on its own or combined with another nose procedure — your surgeon will discuss this at consultation.
Before any incision is made, the surgeon carefully marks the exact area of tissue to be removed with a surgical pen. These markings are measured and checked against pre-op photographs — precise planning is what separates a balanced result from an asymmetric one. Local anaesthetic is then injected to numb the area.
Depending on the technique chosen, incisions are placed either in the natural alar crease where the nostril meets the cheek (alar wedge excision) or inside the nostril itself (nasal sill excision). For external incisions, the surgeon follows the natural skin fold so the scar is hidden within it.
A precise wedge of tissue is removed according to the surgical plan — this is usually only a few millimetres in size, but because the work is so focused, even these small changes create a noticeable overall effect. The surgeon may also use fine cautery to seal small blood vessels and minimise post-op bruising.
The incisions are closed with fine dissolvable sutures that don’t need to be removed. A small sterile dressing is applied to protect the incisions. Unlike full rhinoplasty, there’s no splint to wear. You’ll go to our recovery area for a short observation period, then you can go home — usually within an hour or two of the procedure being finished.
Properly performed alarplasty focuses on the external skin and soft tissue at the base of the nose. It doesn’t involve the internal nasal cartilage or the nasal valve that controls airflow, so breathing isn’t affected. In some cases — particularly where the nostrils were previously constricted — breathing can actually improve slightly. If your surgery is more extensive and involves the internal nasal anatomy, your surgeon will discuss this with you specifically.
Recovery and aftercare
Alarplasty recovery is one of the faster recoveries in nose surgery — there’s no work on the nasal bones, no splint, and no packing. That said, small incisions in a highly visible area of the face still need careful post-op care to heal well. Here’s what to expect.
You’ll go home the same day with small dressings over the incisions. Any discomfort is typically mild — most patients describe it as a dull ache rather than sharp pain. Paracetamol is usually enough. Keep your head elevated above your heart when resting or sleeping, and use cold compresses on the cheeks (never directly on the incisions) for the first 48 hours to limit swelling.
Swelling and mild bruising around the base of the nose peak in the first 3–4 days. You may see a little oozing from the incision sites for 48–72 hours — this is normal. Most patients describe the sensation as tightness rather than pain. At one week you’ll come back to the clinic for a post-op check — the incision sites will be inspected and our post-op nursing team will give you tailored scar-care advice.
Most patients are back to desk-based work within 5–7 days. Avoid blowing your nose for the first two weeks. Hold off on glasses for at least 4 weeks — they press on the healing area. Contact lenses are fine from day one. Light exercise (walking, gentle cardio) can resume from week 2; full exercise from 4 weeks. Avoid anything that risks direct contact with the nose for 6 weeks.
Most of the obvious changes are visible within the first month. Residual swelling at the alar base can take up to 6 months to fully settle — small subtle refinement continues during this time. Scars go through their natural healing phases: initially pink and slightly raised, then gradually fading and flattening over 6–12 months. Keeping incisions out of strong sunlight (with SPF 30+) during the first year helps scars fade to their best final appearance.
Because alarplasty incisions are in a visible area, scar care matters more than for most cosmetic surgery. Our post-op team will provide specific guidance, which typically includes:
Contact the clinic straight away if you experience: sudden heavy bleeding, a temperature over 38°C, severe pain that isn’t controlled by your prescribed medication, or signs of infection at the incision (redness, heat, unusual discharge). Our post-op team is available for calls 24 hours a day.
Our post-op team will call you to check in during the first week. You’ll come back to the clinic for a wound check at one week, and a full surgeon review at 6 weeks. Further reviews can be booked at 3 and 6 months if you’d like to track scar healing.
How much does alar base reduction cost?
The cost of alarplasty depends on whether it’s performed as a standalone procedure or combined with other nose surgery, the anaesthetic used, and the specific techniques needed for your case. There’s no single fixed price — but we can give you a realistic ballpark here, and you’ll get an exact quote at your consultation.
As a guide, standalone alar base reduction at Centre for Surgery typically falls in the range of £3,000 to £4,500. If alarplasty is combined with , , or , the overall quote is higher but works out more cost-effective than having the procedures separately.
Your quote covers everything involved in the procedure — not just the operation itself:
Alarplasty is almost always a cosmetic procedure and isn’t covered by the NHS or private medical insurance. Where the nostril anatomy is creating a genuine breathing issue, an insurer may cover part of the procedure — this is uncommon but worth checking. Our patient coordinators can help you gather the paperwork you’ll need.
Centre for Surgery is partnered with Chrysalis Finance, a specialist medical finance provider, so you can spread the cost of your alarplasty over monthly instalments rather than paying in one lump sum. Plans start from around £120 per month, and 0% APR options are available subject to status. Apply before or after your consultation — you’re not committed to surgery by applying.
Full details of our are on our dedicated finance page, or speak to a patient coordinator directly on to discuss what works for your budget.
Why Choose Centre for Surgery for your alar base reduction
Alarplasty is deceptively simple-looking surgery. The incisions are small and the concept straightforward — remove a tiny wedge of tissue — but the difference between a great result and a disappointing one sits in the millimetres. Asymmetry, over-resection, a visible scar, or a nostril shape that loses its natural curvature are all common complications when alarplasty is performed without the necessary precision. The choice of surgeon matters more than the apparent simplicity of the procedure suggests.
Our surgeons are on the and are members of recognised plastic surgery and facial plastic surgery bodies such as and the . They perform alarplasty and rhinoplasty as a core part of their practice, including significant experience in where alarplasty is a particularly common component.
Our surgeons place incisions in the natural alar crease and use fine-gauge sutures and meticulous closure techniques to keep scars as discreet as possible. Scar care is actively managed throughout the recovery period with structured guidance on cleansing, silicone products, and sun protection — the long-term appearance of the scar is as much a function of aftercare as of surgical technique.
Centre for Surgery is fully registered and regulated by the . Our aftercare programme was specifically rated "outstanding" by the CQC — the highest rating available — reflecting the post-op calls, direct surgeon access for the first 48 hours, and same-day nurse appointments we offer if anything concerns you.
Our surgeons will tell you directly if alarplasty isn’t the right procedure for you — if your concerns would be better addressed by tip rhinoplasty or full rhinoplasty, or if non-surgical options would serve you well before committing to surgery. There’s a mandatory two-week cooling-off period before any surgery is booked. You won’t be chased or pressured at any point.
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We’re partnered with Chrysalis Finance, a specialist medical finance provider, so you can spread the cost of your alarplasty over monthly instalments. .
If you’re considering alarplasty, the best next step is a face-to-face consultation with one of our surgeons. We’ll listen to what you’re hoping to achieve, examine your nostril anatomy carefully, and give you an honest view of what’s realistic in your case.
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Learn More About Alar Base Reduction
If you’d like to read more about alarplasty and nose surgery from independent sources before your consultation, these are the most trusted UK resources:
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