Alar Base Surgery

Abstract

The concept of narrowing the nasal alar base is external wedge excision technique in correction of the excess alar flare while hiding the incision in the alar-facial groove. Weir first described the alar base resection in 1892. In 1931, Joseph and Milstein described narrowing the nostril base and vestibular floor. In 2007, Foda described the combined alar base excision technique for nasal base narrowing in cases of a wide alar base with excessive nasal flare. The alar base plays an important role in the overall appearance and balance of the nose. The alar base, however, is not often evaluated independently during nasal examinations at the time of surgery. As a result, it is one of the most frequently encountered imperfections during secondary rhinoplasty. Deformities of the nasal alar base are a common finding in secondary rhinoplasty. Although some are recognized easily, many deformities are subtle and will be identified only during a detailed examination by the surgeon. A primary deformity that does not occur at the beginning or develops as a secondary deformity, for example, excessive flaring, may develop after reconstruction of the tip projection. When narrowing the alar base, a limited resection is preferred to a comprehensive, since resecting additional alar tissue is simple while having to reconstruct a stenotic alar is a complicated process. In this chapter, alar base surgery is discussed in all aspects.