Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) | Sydney
Nostril width is one of those concerns patients often feel embarrassed to raise at a rhinoplasty consultation, as though it’s too specific or too small to warrant surgery. It isn’t. And it doesn’t necessarily mean full rhinoplasty either. Where the concern is genuinely the alar base, the outer edges of the nostrils, alarplasty is a targeted procedure that addresses exactly that without touching the rest of the nose.
Dr Scott J Turner is a Fellow of the Royal Australasian College of Surgeons (FRACS) with specific training in rhinoplasty and nasal surgery. He consults at his Sydney clinics in Bondi Junction and Manly, with surgery performed at Bondi Junction Private Hospital and Delmar Private Hospital, Dee Why.
What Is Alarplasty?
Alarplasty, also called alar base reduction or nostril reduction surgery, removes small precisely shaped segments of tissue from the alar base — the outer curved portion of each nostril — to narrow the width, reduce outward flare, or correct asymmetry between the two sides. That’s the short version.
The incisions go in the natural crease where the nostril meets the cheek, called the alar-facial groove. It’s chosen because it sits in an existing fold and tends to heal with minimal visible scarring. Nothing happens to the bridge, tip, or internal nasal structure.
The procedure works as a standalone operation or combined with rhinoplasty where both the alar base and other aspects of the nose are being addressed at the same time.
Wide Nostrils vs Alar Flare: What’s the Difference?
These two terms get used interchangeably but they’re not the same thing, and it matters because the technique used to fix each one is different.
Wide nostrils is about base width — the overall distance from one side of the alar base to the other. Too wide relative to the nose or face. The fix is alar base resection, removing tissue from the nostril sill at the base.
Alar flare is about how much the nostrils curve outward when viewed from the front. A patient can have normal overall base width and still have significant outward flare. The fix is alar wedge excision, removing a wedge from the outer alar curve without touching the base width.
Some patients have both, in which case a combined approach deals with both at once. Working out which is the actual concern, or whether it’s both, is part of what happens at consultation.
What Alarplasty Can and Can’t Address
It helps to be clear about the scope of this procedure before considering it.
Alarplasty addresses:
- Nostril width disproportionate to the nose or face
- Alar flare — nostrils that curve visibly outward
- Asymmetry between the two nostrils in size or shape
- Nostril width that has become disproportionate following rhinoplasty where the bridge or tip were narrowed
Alarplasty does not address:
- The nasal tip, bridge, or dorsal profile
- Breathing problems or internal nasal structure
- Concerns about the overall size or shape of the nose beyond the alar base
Where the concern extends beyond the nostril base, the conversation about whether a broader rhinoplasty is more appropriate is worth having at consultation. For the full cosmetic rhinoplasty overview, see cosmetic rhinoplasty.
Who Is a Good Candidate for Alarplasty?
Alarplasty may be appropriate if you:
- Have a specific concern about nostril width, alar flare, or nostril asymmetry that bothers you
- Are satisfied with the rest of your nose — the tip, bridge, and overall size — and would not benefit from a broader rhinoplasty
- Have realistic expectations about what the procedure can achieve and understand that results depend on individual tissue characteristics and healing
- Are in good general health with no conditions that significantly increase surgical risk
- Are a non-smoker, or can stop smoking well before surgery — nicotine significantly impairs wound healing and is particularly important in procedures with external incisions
- Have fully developed facial anatomy
Where a patient’s primary concern is the tip or bridge, and nostril width is a secondary observation, alarplasty alone is usually not the right starting point.
Alarplasty Combined with Rhinoplasty
Combining alarplasty with rhinoplasty at the same operation is common, and there are good reasons to do it rather than treating them as separate decisions.
Other nasal changes shift the proportions. Narrowing the bridge or refining the tip changes the overall balance of the nose. Nostrils that looked fine before those changes can appear relatively wider afterwards. Planning alarplasty alongside the rhinoplasty means the result is proportionate across the whole nose from the start, rather than requiring a second procedure to fix something that changed.
One operation is simpler than two. One anaesthetic, one recovery period, one quote. Doing them sequentially means doing it all twice.
Better intraoperative planning. When both are done together, the surgeon can judge how much alar reduction is appropriate in the context of the changes being made to the rest of the nose, rather than guessing at a second operation what the right amount would have been.
For patients of ethnic backgrounds where alar base width is a more common and significant concern, particularly Asian, African, and Middle Eastern patients, alarplasty is frequently part of the rhinoplasty plan rather than an afterthought.
The Surgical Techniques
Three approaches are used, depending on what the anatomy requires.
Alar wedge excision. The most common technique for alar flare. A wedge of tissue is removed from the outer alar curve, reducing how far the nostril extends outward when viewed from the front. The incision stays within the alar-facial groove and does not enter the nostril opening itself.
Alar base resection. Used to reduce the overall width of the nostril base by removing tissue from the nostril sill — the horizontal strip at the base of each nostril where it meets the upper lip. This narrows the distance between the nostrils at their base.
Combined approach. Where both alar flare and overall base width are concerns, both techniques may be used in the same operation to address both dimensions.
All techniques are performed through incisions placed in the alar-facial groove. The goal is a result that looks proportionate and settled, not operated.
AHPRA Regulatory Requirements
Under AHPRA cosmetic surgery guidelines (effective 1 July 2023), the following apply before alarplasty can proceed:
- A referral from your GP or a specialist physician
- A minimum of two consultations with Dr Turner before surgery is booked
- A psychological evaluation to confirm suitability
- A mandatory cooling-off period before formal consent is given
Recovery
Recovery from standalone alarplasty is notably more straightforward than full rhinoplasty, as the nasal bones are not involved.
Week 1. Sutures in place. Some swelling and bruising around the nostril bases. Rest and avoiding nasal impact is important during this period. Avoid blowing the nose.
Suture removal at approximately one week. External sutures are removed at the post-operative appointment. Some swelling and firmness at the incision sites is normal at this stage.
Weeks 2 to 3. Most visible swelling resolves. Many patients feel comfortable in public settings by two weeks. Return to desk-based work is typical during this window.
Weeks 4 to 6. Avoid strenuous exercise and contact sport.
Months 3 to 12. Incision lines continue to mature and fade. Final scar appearance at six to twelve months depending on skin type and sun protection behaviour.
Where alarplasty was combined with rhinoplasty, the recovery follows the rhinoplasty timeline — external splint for one week, visible bruising for two to three weeks, final result at 12 months.
Will There Be a Visible Scar?
This is the question that comes up in almost every alarplasty consultation, and it deserves a straight answer rather than reassurance.
Incisions go in the alar-facial groove because that natural crease helps conceal them. For most patients the line fades substantially over six to twelve months and isn’t noticeable at normal social distances. But scarring is individual. Skin type, sun exposure during healing, and how you personally heal all affect the final result. Patients with a tendency toward hypertrophic scarring or keloid formation are at meaningfully higher risk and need to know that before deciding to proceed.
Sun protection over the incision sites during recovery is important. Dr Turner will discuss what to realistically expect based on your skin at consultation.
Is Alarplasty Covered by Medicare?
No. Alarplasty is a cosmetic procedure. It does not address internal nasal function and does not meet the criteria for any Medicare Benefits Schedule item number. Private health insurance does not cover it when performed for cosmetic purposes.
The cost varies depending on whether it is performed as a standalone procedure or combined with rhinoplasty. For a full breakdown of rhinoplasty and associated procedure pricing, see the rhinoplasty cost guide.
Frequently Asked Questions
What is alar base reduction and what does it involve?
Alar base reduction, also called alarplasty or nostril reduction surgery, is a procedure to reduce the width or flare of the nostrils. Precisely shaped segments of tissue are removed from the alar base through incisions placed in the natural crease where the nostril meets the cheek. It may address overall nostril width, alar flare, nostril asymmetry, or a combination. The procedure is performed under general anaesthetic and typically takes approximately one hour as a standalone operation. Recovery involves suture removal at one week, with most visible swelling resolving within two to three weeks.
How much can alarplasty reduce nostril width?
The degree of reduction that is appropriate depends on your individual anatomy, facial proportions, and what the skin and soft tissue will accommodate. Over-reduction is one of the more significant risks in alarplasty — removing too much tissue can produce a result that is unnatural, difficult to correct, and in some cases irreversible without further surgery. Dr Turner plans the degree of reduction carefully based on your anatomy and will discuss realistic expectations at consultation.
Will alarplasty leave visible scars?
Incisions are placed in the alar-facial groove, the natural crease where the nostril meets the cheek, specifically to minimise scar visibility. For most patients, incision lines fade considerably over six to twelve months. Individual scarring varies by skin type, healing behaviour, and sun exposure during recovery. Patients with a history of hypertrophic or keloid scarring should discuss this at consultation. Sun protection over the healing incision sites is important.
Can alarplasty be reversed?
Alarplasty is not easily reversible. Tissue that has been removed cannot be replaced without complex reconstructive surgery, and the results of such reconstruction are unpredictable. This is why over-reduction is taken seriously, and why careful planning of the degree of reduction is a critical part of the procedure. Patients should be clear and certain about their goals before proceeding.
Is alarplasty suitable for patients of all ethnic backgrounds?
Yes. Alarplasty is performed across a wide range of ethnic backgrounds and is particularly common among patients of Asian, African, Middle Eastern, and Hispanic heritage, where a wider alar base is a more frequently presenting concern. The surgical approach and degree of reduction are planned in the context of the patient’s overall facial anatomy and the aesthetic goals that are appropriate for their specific features. For more on rhinoplasty in ethnic patients, see ethnic rhinoplasty.
Consult with Dr Scott J Turner
Dr Turner consults for alarplasty and rhinoplasty in Sydney at Bondi Junction and Manly. He also sees patients in Brisbane, Canberra, Newcastle, and the Gold Coast. Surgery is performed in Sydney at Bondi Junction Private Hospital and Delmar Private Hospital, Dee Why.
Contact the practice to arrange a consultation, or read more about Dr Turner’s background and training.
