Endonasal Alarplasty Columellaplasty

Endonasal alarplasty columellaplasty

The traditional procedure wherein the size of the nostrils are surgically reduced is known as alarplasty. During this process, the surgeon removes some skin in the shape of a wedge with the objective of creating nostrils that are smaller and more symmetrical. This procedure reduces the alar base width in some of the cases, but in most of them we also need to reduce the columellar base width to get a better result. Columellar base is the part of nose that stays in the middle part of the base of nose. If we reduce the base of nose in the middle part, we may not need to cut the alar part in most of the cases of rhinoplasty. This procedure, reducing the columellar base width, is performed endonasaly without cutting the skin structure. In most of the cases it is a component of ethnic rhinoplasty for African American and Asian nose. In some rare cases the patient just need alar plasty without any need to columella plasty, in this case it is performed under local anesthesia as a simple procedure.

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Endonasal alarplasty columellaplasty

  • On average, a person who undergoes endonasal alarplasty columellaplasty takes seven days to recover
  • The outcome of endonasal alarplasty columellaplasty is permanent
  • Endonasal alarplasty columellaplasty is performed using surgical methods under general anesthesia

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About the Procedure

In Turkey, rhinoplasty is a widely used plastic surgery treatment and Dr. Avsar often employs it to straighten bridges that are crooked, smoothen bumpiness, and even to decrease the size of the tip of the nose. Dr. Avsar performs this procedure with endonasal approach and he alters your nostrils to the ideal shape if you need alarplasty columellaplasty. It can be performed in combination with tip plasty and septoplasty as well. It is only when the alar structure so big, I cut them with wedge plasty and this probability matches with less than 10 percent of the cases. The amount of nasal tissue that must be removed is determined by intraoperative marks. The shape of the tissue that is removed is largely depends on the anatomy of the alae. Almost always alar plasty columella plasty is the last part of the operation. At the end stage of every rhinoplasty procedure Dr. Avsar performs columella plasty and reduce the alar base width as much as it is possible. Then he decides if the patient needs the alar plasty or not. For alar plasty Dr. Avsar firstly makes an incision outside the crease connecting the nostril to  cheek. This incision will be continued even inside the nose and goes on around the markings. At this point, he excises the tissue and leverage the technique of laying down sutures to attach the nostril and the base of the nose again, albeit this time, at a narrower position. This same process is adopted on the opposite nostril as well. Fortunately, a patient will not have to deal with incisions and scars as they are naturally masked by the nose’s creases. If the alae are asymmetric, it is possible to balance them with planned resections.

The objective of an endonasal alar plasty columella plasty procedure is to ensure that the nose looks more narrow, by decreasing the size of the nostrils.

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Purpose of endonasal alarplasty

With an endonasal alarplasty columella plasty, several issues can be managed, which include:

  • Size of the nose
  • Shape of the nose
  • Nasal base width

What to Expect

As stated before, endonasal  alarplasty columellaplasty is useful to reduce the size of the nostrils through surgical means. Let us look at a quick guide pertaining to what a patient can expect before, during, and after an endonasal alarplasty columellaplasty procedure.

Prior to Endonasal  Alarplasty columellaplasty

  • For two weeks prior to the procedure, blood thinners must not be used
  • Alcohol must not be consumed for at least two days before and after the procedure

While Endonasal Alarplasty columellaplasty

  • To perform endoscopic columellaplasty, general anesthesia is used. For stand alone alar plasty local anesthesia will be enough.
  • Columellaplasty is an endonasal approach without any cut. The incision for alarplasty is employed over the nasal crease.


  • Swelling may be observed after columellaplasty, but it is scant for alarplasty
  • The surgery may cause some bruising and redness
  • The procedure is painless in most of the cases

One-Three Weeks Post-Treatment

  • Incisions must be cleaned every day for alar plasty
  • The patient can resume work after 1 week
  • For one-two weeks, swelling will remain
  • The patient must not engage in intensive exercise for four weeks

Result Notes

  • Immediately after the surgery, the transformation will be noticeable
  • After four weeks, final results may be observed
  • The patient will continue to notice improvements for several months
  • Outcome is permanent

Alarplasty Columellaplasty Recovery Notes

Typically, patients tend to recover from alarplasty at a relatively quicker pace in comparison to endonasal columellaplasty. For some time patient may observe swelling and redness of the suture lines. Sutures are absorbed by themselves in 2 weeks. The majority of patients demonstrate complete recovery within one-two weeks, following which, only mild swelling may be observed for another month.

Ideal Applicants

Endonasal columellaplasty is suitable for patients with broad alar base. Alarplasty is ideal for individuals with stand alone large, asymmetric, or prominent alae and want to decrease the size to ensure that their facial features are more balanced.

Inappropriate Applicants

I do not recommend performing endonasal alarplasty columellaplasty for individuals aged under seventeen unless the cause for an anomaly is due to injury and heavy breathing problem. However, it is important to assess each case to determine the requirement of surgery as children tend to mature at a diffearent rate- both physically and emotionally.


Nostrils are smaller and more symmetrical, leading to balanced facial features. General anesthesia is employed and the recovery process is very quick.


For alarplasty the procedure may leave patients with scars and it is why Dr. Avsar recommends perorming endonasal columellaplasty prior to reducing the alae with alarplasty as this procedure makes the patients so much happy without scars.