Alar Rim Surgery

Alar rim surgery is the name plastic surgeons use when they are talking about changing the shape of a patient’s nostrils. Most lay people call it nostril surgery. Dr. Freeman recommends that alar rim surgery not be done at the same time as a rhinoplasty or a revision rhinoplasty. There are many reasons for this but the most important one is that when a rhinoplasty is performed to change the shape of the tip cartilage, that surgery is going to change the shape of the nostril in a non-quantifiable way.  Dr. Freeman is one of America’s most experienced nose surgeons. 

Therefore, if the surgeon did the alar rim surgery at the same time, they would be operating on a nostril whose shape is going to change after the rhinoplasty, not a good idea. Other reasons being that the incision for alar rim surgery is visible and the swelling from the rhinoplasty would make it heal with a more visible scar. In addition, alar rim surgery is almost always done under local anesthesia following a nerve block and has minimal swelling and bruising, in general, a patient-friendly procedure. Another point is that in Dr. Freeman’s experience of over 30 years only about 6-8% of rhinoplasty patients decide they want alar rim surgery, which means many surgeons are overperforming this procedure and conversely patients are overpaying for a procedure they may not need.

There are two types of procedures done during alar rim surgery. One is called a Weir procedure. A Weir procedure is done for flaring of the nostril after a rhinoplasty and is more likely to be seen in patients having a reduction rhinoplasty (making a bigger nose smaller). The other is called a nasal sill procedure. This procedure is more common in patients needing an augmentation rhinoplasty. In other words, patients who need structure added to their nose for improvement in definition and nostril shape. Many of these patients have an African/Asian/Indian background in their genes. Many times, both procedures are needed.

There are many photos of Dr. Freeman’s patients who went on to have alar rim surgery afterward in the photo gallery. Click on the tab that reads Rhinoplasty with Alar Rim.

Click here to see more Before and After photos of Dr. Freeman’s patients who have had Alar Rim following a Rhinoplasty Surgeries.