Learn about Alarplasty + Tip-Plasty

What is Alarplasty?

Alarplasty is one of the most precise procedures in nasal surgery. Small changes make a big difference, and careful technique is essential for a natural result.

Alarplasty is a procedure that reduces the width of the nostrils by removing a small amount of tissue where the nostril attaches to the cheek. The incisions are placed in the natural crease so the scars remain well hidden.

Although alarplasty is a relatively quick procedure, it must be performed in a very conservative and precise manner. Removing too much tissue can affect both nasal breathing and the natural appearance of the nose. The goal is refinement and balance — not simply making the nostrils smaller.

Various techniques have been described to narrow the nostrils, including suture techniques that pull the nostrils toward the center. In most cases, I prefer a small excisional technique because it provides a more predictable and stable result.

My Approach

For alarplasty, I typically remove a small triangular wedge from the outer side of the nostril. I intentionally preserve about 1 mm of the natural alar groove skin where the nostril meets the cheek.

Preserving this small strip maintains the natural transition between the nose and the cheek and helps camouflage the incision. This approach produces a natural appearance while safely narrowing the nostrils.

What is Tip-Plasty?

Tip-plasty refers to surgical refinement of the nasal tip. The goal is to improve tip definition and balance while preserving a natural appearance. The nasal tip can appear enlarged because of excess cartilage, thick skin, or fatty tissue. When the tip appears round and full, it is often described as a bulbous tip.

Tip-plasty can be performed as a stand-alone procedure or combined with alarplasty. I commonly see patients whose upper nose is already well defined, but the lower part of the nose appears wider because of a bulbous tip and flared nostrils. This pattern is frequently seen in ethnic rhinoplasty patients, including many African-American patients.

Open vs Closed Tip-Plasty

Patients often encounter the terms open rhinoplasty and closed rhinoplasty when researching tip surgery. The difference between these approaches is smaller than most patients expect.

In the open approach, a small incision is made on the skin underneath the nasal tip. This allows the skin to be lifted so the cartilages can be seen directly.

In the closed approach, all incisions are inside the nose and there is no visible external incision. Both techniques can produce excellent results. The choice depends on the anatomy and surgical goals rather than one approach being universally better.

I use both approaches. For many patients — especially those undergoing alarplasty at the same time — a closed tip-plasty works very well. If a patient is unsure whether both procedures are needed, we often start with the area that is the biggest concern. The second procedure can always be performed later if necessary.

Combining Alarplasty and Tip-Plasty

The lower half of the nose may appear large because of both wide nostrils and a bulbous tip. Treating both areas at the same time often produces the best balance. These procedures are usually performed under local anesthesia without general anesthesia. No rib cartilage, ear cartilage, implants, or grafts are required.

Tip-plasty focuses on reshaping excess cartilage and soft tissue, while alarplasty narrows the nostrils by removing a small amount of tissue from the sides. The combined procedure typically takes about 1 to 1½ hours.

A small nasal cast is worn for one week. Most patients remove the cast themselves at home with our guidance. The stitches dissolve on their own and do not need to be removed. Most patients return to work after about one week, and normal activities can usually be resumed after two weeks.

Staged Procedures

Some patients prefer to stage the procedures rather than do both at once. One procedure is performed first and allowed to heal fully. After about a year, the patient can decide whether the second procedure is still needed.

This approach allows patients to proceed comfortably and avoid unnecessary surgery.

Traveling Patients

Many patients travel for alarplasty and tip-plasty. The procedures are performed under local anesthesia, so patients can return home shortly afterward. Follow-up visits can usually be done virtually, so an additional trip is often not necessary.

For more information on nostril reduction surgery or to schedule an appointment, contact us toll-free at 877-JANJUA1.

Our location in Bedminister, NJ is within a convenient distance from Morris, Hunterdon, Somerset County, New Jersey, and Philadelphia and New York.

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