Alar Base Reduction in London
What is an alar base reduction?
Alar base reduction, also known as alarplasty, is a procedure that refines the width and contour of the nostrils to bring the nose into better proportion with the rest of the face. It focuses on the lower part of the nose, the alar base, where the nostrils meet the cheeks. By making small, precise adjustments, the aim is to achieve a subtle, natural balance rather than a dramatic change.
At Real Plastic Surgery, Mr Naveen Cavale, Consultant Plastic and Reconstructive Surgeon, approaches every alar base reduction with care and precision. Using fine incisions hidden in the natural creases of the nostrils, he gently removes or repositions small amounts of tissue to narrow wide or flared nostrils while preserving the natural curvature and structure of the nose.
This technique is most commonly performed in patients with naturally broader nasal bases, often seen in individuals of African or Afro-Caribbean heritage. In these cases, the goal is to refine the nasal shape while maintaining ethnic identity and achieving beautifully balanced results.
The result is a refined nasal shape that fits harmoniously with your facial features, enhancing rather than altering your appearance. In some cases, the procedure can also strengthen the nostril rims to improve airflow and breathing comfort.
Alar base reduction can be performed as a standalone procedure or combined with a rhinoplasty or septorhinoplasty for a more comprehensive outcome. Each operation is tailored to the patient’s anatomy, goals, and overall facial proportions to ensure results that look balanced, natural, and long-lasting.
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Before and After
Why consider an alar base reduction?
The shape and width of the nostrils have a profound influence on facial aesthetics. For some, wide or asymmetric nostrils can make the nose appear disproportionately large or distract from other features. Alar base reduction gently reshapes this area to create better proportion and balance. The procedure can also be beneficial for patients with functional concerns, such as nasal valve weakness or airway narrowing, improving both breathing and appearance.
Alar base reduction can:
- Create balanced proportions between the nostrils and the nasal bridge
- Improve symmetry and refinement from the front view
- Subtly reduce nostril flare while smiling or speaking
- Reinforce the alar cartilage for improved structural support and airflow
- Deliver natural, harmonious results with minimal recovery time
Mr Cavale’s approach is precise and conservative, focusing on refinement rather than transformation to give his patients natural, long-lasting results. Every adjustment is made to preserve your individuality while restoring balance and confidence.
Types of alar base reduction techniques
Alarplasty can be performed using several techniques, chosen according to your anatomy and desired outcome. During your consultation, Mr Cavale will discuss which method best suits your goals.
Alar wedge excision
This technique removes a small wedge-shaped piece of tissue where the nostril meets the cheek (the alar base). It narrows the nostril width without affecting the natural curvature of the nose. Incisions are hidden within the crease, leading to minimal visible scarring and a subtle, natural refinement.
Nasal sill excision
A small incision is made inside the nostril to remove excess tissue from the inner base. This reduces nostril width internally and further limits visible scarring. It is often combined with the alar wedge excision for enhanced symmetry and proportion.
V-Y advancement
Mr Naveen Cavale generally avoids using the V-Y advancement technique, as it can leave more visible scarring around the nostrils. He prefers alternative methods that achieve natural refinement of the nasal base with subtler, better-concealed scars.
By selecting the most suitable technique, or combination of techniques, Mr Cavale customises every alarplasty to meet your specific aesthetic and functional needs.
Alar base reduction vs alar rim correction
While alar base reduction narrows and reshapes the nostril openings, alar rim correction (or treatment for alar rim retraction) focuses on lowering or restoring the outer edge of the nostrils.
Alar rim retraction occurs when the rim of the nostril sits higher than the base of the nose, creating an angular, upturned appearance. It may result from previous surgery, congenital factors, or trauma, and can cause weakness in the nasal cartilage, leading to valve collapse and breathing difficulties.
In alar rim correction, fine cartilage grafts, taken from the septum, ear, or a synthetic source, are placed to restore a smooth, even curve to the nostril edge. This provides both aesthetic improvement and better structural support for the nasal valves.
Patients occasionally require a combination of alar base reduction and rim correction to achieve a balanced, symmetrical nasal base that functions properly.
Treatment Time
Between 2 and 2.5 hours. We use a general anaesthetic and you can usually go home on the same day.
Downtime
10 - 14 days off work.
Reasonable Mobility
We recommend patients begin gentle movement around two days after surgery. Light activities such as walking, climbing stairs, and carrying out basic daily tasks are encouraged to support circulation and recovery.
Sport & Exercise
You can begin exercising and doing more strenuous activities at six weeks.
Driving
Most patients can resume driving two weeks after surgery, provided they feel comfortable.
Shower
You can shower the day after surgery, but it's important to keep any wounds and dressings clean and completely dry.
Full Recovery
Between six months to a full year. While most swelling subsides within the first few months, subtle changes and final results may continue to develop over time.
Maintenance
Rhinoplasty provides a permanent solution. It can be combined with other surgical and non-surgical procedures when looking to rejuvenate the appearance and reduce signs of ageing.
Reason for doing this?
To address aesthetic and structural concerns such as dorsal humps, nasal deviation, asymmetry, or disproportionate nasal size. The procedure also aims to improve nasal contour and function, including correction of breathing difficulties caused by internal nasal obstruction (e.g. deviated septum).
Reasons to Avoid
If you have any doubts. Our team of experts will support and guide you through your treatment journey. During your consultation, Mr Cavale will determine your suitability and your certainty.
The Patient Journey: Alar Base Reduction
Your consultation with Mr Naveen Cavale takes place at the REAL Clinic in Battersea, lasting around 30 minutes. During this time, he will examine your nasal anatomy, assess airflow and structural strength, and discuss your goals. Virtual consultations are also available, but an in-person review is required before surgery. To book your alar base reduction consultation, visit our booking page here.
Alar base reduction can be performed under local anaesthesia, a straightforward option with minimal downtime and lower cost. Alternatively, it can be done as a day-case procedure under TIVA (total intravenous anaesthesia), which typically takes around an hour. If you choose this option, you’ll need someone to stay with you overnight after surgery.
Postoperative care includes:
- Direct contact with our nursing team via WhatsApp or phone
- A one-week follow-up to remove fine stitches and assess healing
- A six-week review to monitor progress and symmetry
Most patients return to work within a week, with swelling continuing to improve over the following month. If you have concerns during recovery, Mr Cavale and the team are always available to provide reassurance and advice.
What to Expect on the Day:
On the day of your procedure, you’ll meet Mr Cavale to review your plan and ensure all details are clear. Surgery can either be performed under local anaesthesia, a simple, lower-cost option with minimal downtime, or as a day-case under TIVA general anaesthesia for maximum comfort and a smooth, rapid recovery.
The operation takes approximately 60–90 minutes, and you’ll return home later the same day. Fine stitches are placed inside the nostrils or along the natural crease at the base of the nose. These are either dissolvable or removed at your one-week appointment.
You can shower the next day, keeping the nose dry until stitches are removed. Mild swelling or tightness is normal and settles within 1–2 weeks. Most patients see refined results within a few weeks, with continued improvement over time.
Book a Consultation
Every transformation starts with a conversation. During your consultation at Real Plastic Surgery, we’ll take the time to understand your concerns, assess your goals, and create a tailored treatment plan that’s right for you. Book your consultation today and take the first step towards feeling your best
Frequently Asked Questions
What’s the difference between alar base reduction and full rhinoplasty?
Full rhinoplasty reshapes the entire nose, including the bridge and septum, whereas alar base reduction focuses only on the lower third. It’s ideal for patients happy with their nasal bridge and tip and want to refine nostril width or shape.
Can alar base reduction help improve breathing?
Yes. In cases where weak or flared cartilage contributes to nasal valve collapse, alarplasty can restore support and improve airflow. If internal obstruction is also present, Mr Cavale may recommend combining alarplasty with a septoplasty or tip refinement.
Will there be visible scars?
Incisions are carefully placed within the natural creases of the nostrils to make scars virtually undetectable once healed. Over time, they fade to blend seamlessly with the surrounding skin.
How long is the recovery?
Most patients can return to work or social activities within one week. Light swelling and redness may persist for several weeks but continue to improve. Avoid strenuous exercise for around two weeks, and expect full healing within four to six weeks.
Are the results permanent?
Yes, the results of alar base reduction are designed to be long-lasting. The nostrils retain their refined shape once healed, though natural ageing may subtly alter nasal skin and soft tissue over time.
Who is suitable for alarplasty?
Alarplasty may be suitable if you:
- Have wide or asymmetric nostrils that affect facial proportion
- Experience breathing difficulties due to cartilage weakness
- Have nasal asymmetry from birth or injury
- Wish to enhance the fit of CPAP or other nasal devices
- Are in good general health and seeking subtle, natural improvement
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