Surgical Name : Alarplasty / Nostril Reduction
Hospital Admission: No hospital admission for out patient case
Duration of Operation: 1 - 2 hours
Anesthetic: Local Anesthesia
Recommended stay in Bangkok: 5 - 7 days

Who benefits from alarplasty?

• Clients with excessive wide nostrils.
• Clients with asymmetrical nostrils.

How is alarplasty surgery performed?
During alarplasty, the surgeon administers local anesthesia and makes an incision either on the outside or inside of the nose in the alar region. Then the surgeon removes a specific amount of tissue. Once this tissue is removed, the incision is sutured. This tightens the span of wide nostrils. Bone and cartilage are not touched with an alarplasty, so your recovery is easier.

Pre-Operative Care
Preoperative counseling should examine how to harmoniously balance the patient’s aesthetic needs as related to ethnicity, facial characteristics, and patient treatment goals. Since the alar base varies considerably from person to person, a dogmatic approach and application of the classic canons of alar base aesthetic ideals will result in dissatisfied rhinoplasty patients.

Please avoid aspirin and brufen-containing medication for two weeks prior to surgery to eliminate the chance of post op bleeding.

Post-Operative Care
Alar base incisions will tend to crust if not cared properly. Patients are seen on postoperative day number one and incisions are inspected, all crusts are debrided and antibiotic ointment is applied. Typically, sutures are removed from the wedge excision on postoperative day five. However, consider removal at day seven or eight if wound healing is not sufficient. Steristrips can be used to reinforce the wound to assist healing. Sutures along the sill may be left in place for up to two weeks.

Post-op Instructions
Avoid “sniffing”, that is, forcibly attempting to pull air through the nose as some people do when their noses feel blocked. This will not relieve the sensation of blockage – it will only aggravate it because the suction created on the inside will cause more swelling. Avoid constantly rubbing the nostrils and base of the nose with Kleenex or a handkerchief. Not only will this aggravate the swelling, but it may cause infection, bleeding, or the accumulation of scar tissue inside the nose.
Ice compresses should be applied diagonally across each eye for twenty minutes every two hours while awake during the first two days after discharge from the hospital are helpful.

You may clean the outside of the nose soon after the bandage has been removed, the nose should be cleaned in the usual manner twice daily to remove the oily material that is produced by the skin glands. This is important because otherwise swelling will be prolonged. The nose can withstand gentle cleaning at this time.

Avoid excessive grinning and smiling. Don’t pull the upper lip down as women do when they apply lipstick. Apply lipstick with a brush. The upper teeth should be cleansed with toothpaste on a face cloth; the lower teeth may be brushed as usual. Also avoid gum or foods that are hard to chew. Soft or liquid diet is recommended.

You have to stay up (sitting, standing, walking around) as much as possible when you leave the hospital. Avoid bending over or lifting heavy things for one week. Besides aggravating swelling, this may raise your blood pressure and start bleeding. Avoid hitting or bumping your new nose. It is not wise to pick up small children.

Sleep with the head of the bed elevated until all the dressings have been removed from the nose. Try not to roll on your nose.

Report any excessive bleeding that persists after pressure and lying down for 15 minutes.