Is Alarplasty Just About Narrowing the Nose Wings? | Kowon Plastic Surgery

Hello, this is Dr. Kim Hyung-taek of Kowon Plastic Surgery.

The case I'm sharing this time involved an upturned nose, where the tip lifts upward and the nostrils are highly visible from the front, along with the features of a dragon nose, where the tip itself appears short and lifted.

The nose wings also flared outward, leaving the nostrils fully exposed, which gave the overall impression of a somewhat light and awkward look.

When correcting this type of appearance, I don't simply reduce the size of the nostrils or narrow the nose wings alone. I believe it's important to look at which direction the tip is pointing and how the surrounding cartilage and structures relate to each other, so that the overall proportions come together.

First, I organized the upward-displaced tip structure through tip cartilage repositioning and tip cartilage suturing. I then created a support strut between the tip cartilages to reinforce the structure so the tip could settle stably in a lower position. When I perform tip refinement at Kowon Plastic Surgery, I place great importance on these structural aspects.

Through this process, I was able to ease the excessive upward lift of the tip that was prominent in upturned and dragon noses, and adjusted the nostrils, which had been overly visible from the front, so that their exposure naturally decreased. As a result, the tip settled more securely than before, and the overall impression shifted toward something softer.

Another important area to examine is the columella. When the columella appears short or flat, the nose wings can look relatively more prominent, so rather than correcting only the tip on its own, it's necessary to also check the relationship between the columella and the nasolabial angle.

Before-and-after side view from below: the nostrils show clearly before; the after photo shows fresh stitches along the nostril wing.

In this case as well, I supplemented the length of the tip while adjusting the columella to balance the lower part of the nose. As a result, the nostril shape became more naturally refined, and the plan was designed so that the flared nose wings would also improve, achieving the effects of alarplasty.

"In fact, just because the nose wings look wide doesn't mean they need to be reduced from the start."

That's because in some cases, simply gathering the tip also tidies up the width of the lower nose. Therefore, correcting the tip structure first can naturally ease the flaring of the nose wings.

However, if the nose wings themselves are lifted outward, as in this case, the approach may differ. In particular, when the muscles that hold the nose wings in their current position are strong, it can be difficult to achieve the desired shape with tip structure alone. In such cases, we consider a method that uses cartilage to supplement the position and shape of the nose wings. This is called alarplasty.

That's why, when correcting shapes like upturned or dragon noses, where the nostrils are highly visible from the front, it's important to comprehensively assess the direction of the tip, its internal structure, and the relationship between the columella and the tip, rather than simply reducing the size of the nostrils. When I consult on these cases at Kowon Plastic Surgery, I tend to first check the structural balance of the entire lower nose rather than focusing on just one visible area.

Ultimately, what matters is not reducing the overexposed nostrils and the flared nose wings separately, but harmoniously organizing the overall structure, including the tip and the columella.

In this case, I took the same approach, correcting the nose so that nostril exposure and nose wing flaring were both refined, leading to a more stable and balanced nose shape. When needed, considering alarplasty alongside other procedures is also one way to achieve this structural balance.

[Related Case]

This case involved a short, upturned tip, tip asymmetry skewed to one side, and nose wings that flared out to each side. In particular, rather than the tip itself being broadly spread out, the nose wings were splayed outward, so I judged that adjusting the width of the nose wings together was more appropriate than simply reducing the tip alone.

Before (left) and after (right) viewed from below: the nostril wings look narrower in the after photo.

During surgery, I first lengthened the short tip to an appropriate length while refining the shape of the spread-out tip, and at the same time performed alar reduction to naturally narrow the width of the lower nose. I also corrected the tip asymmetry that leaned to one side, improving the appearance of the nose looking bent from the front. In addition, for the low, petite-looking nasal bridge, I used silicone appropriately to enhance the three-dimensional structure and balance of the entire nose.

Before (left) and after (right) from an angled view: the nostril wings appear slimmer in the after photo.

As a result, the short, upturned tip became more naturally lengthened, and the nose wings and tip that had spread sideways were neatly refined. As the asymmetry improved, the nose looked more stable, and from the profile and 45-degree angle, the overall nasal line became cleaner, shifting to a softer and more natural impression.

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[What I Value Most in Surgery]

"For cases like upturned or dragon noses, where the nostrils are highly visible and the nose wings look flared, it's important to examine the direction of the tip, the cartilage structure, and the relationship between the columella and the nose wings, rather than just reducing the visible parts."

In consultations and during surgery, rather than simply making the nose smaller, I first consider which parts should be adjusted and how, within the existing structure of the nose, to improve overall balance. Especially when the relationship between the tip and the nose wings is key, I carefully determine the necessary scope of correction, focusing on creating natural changes without overdoing it.

Because even small changes can dramatically alter the impression from the front and the side, it's important to consider the harmony of the whole nose rather than correcting based on just one part. At Kowon Plastic Surgery, we build surgical plans suited to each person's nasal shape and structure based on these principles.

Ultimately, what matters is not making the nostrils less visible or narrowing the nose wings at all costs, but balancing the tip, columella, and nose wings so they blend naturally. Going forward, I will continue to carefully assess these structural aspects, placing the highest priority on creating a natural and stable nose shape.

Frequently Asked Questions

Is alarplasty just a procedure to reduce the nose wings?

No. The article describes alarplasty as a method that uses cartilage to refine the position and shape of the nose wings. The author notes that they do not approach it by simply narrowing the width of the nose wings.

For upturned or dragon noses, is it enough to just reduce the size of the nostrils?

No. The article explains that it does not rely solely on reducing nostril size. Instead, it also examines the direction of the tip, the cartilage structure, and the relationship between the columella and the tip.

If the nose wings look wide, are they reduced right away?

No. According to the article, just because the nose wings look wide doesn't mean they need to be reduced from the start. In some cases, simply gathering the tip also tidies up the width of the lower nose.

What is done when the nose wings are lifted outward?

Alarplasty, which uses cartilage to refine the position and shape of the nose wings, may be considered. The article explains that when the nose wings are lifted outward and the muscles that keep them in place are strong, it may be difficult to achieve the desired shape with tip structure alone.

What happens if the columella is short or flat?

The nose wings may look relatively more prominent. For this reason, the article explains that rather than correcting the tip alone, the relationship between the columella and the nasolabial angle should also be checked.

Is the surgical approach the same for everyone?

No. The article explains that the scope of correction and surgical plan are tailored to each person's nasal shape and structure, aiming for natural changes without overdoing it.