Alarplasty — surgical narrowing of the nostrils — addresses wide nostril base or flared nostrils that don\'t respond to bridge augmentation alone. The procedure is brief, performed under local anesthesia, and produces permanent results. Korean rhinoplasty practice often combines alarplasty with bridge work for comprehensive nasal reshaping. This guide explains the techniques.
What alarplasty addresses
- Wide nostril base (interalar distance too large).
- Flared nostrils that show too much when smiling.
- Asymmetric nostril shape.
- Round or oval nostrils preferred to be more elongated.
- Persistent nostril width after rhinoplasty bridge work.
The two main techniques
Wedge excision (alar base reduction)
- Removes a wedge-shaped piece from outer alar where it meets cheek.
- Reduces alar flare.
- External incision in alar-facial groove.
- Scar hidden in natural crease.
- Doesn\'t narrow nostril opening itself.
Sill excision (nostril sill reduction)
- Targets the nasal sill (floor of nostril).
- Narrows nostril opening.
- Reduces interalar distance.
- Internal incision (inside nostril).
- No external scar.
Combined wedge + sill
- Both flare and width addressed.
- Most comprehensive reduction.
- Some external scar in alar groove.
- Used for substantial reduction needs.
Cinched suture technique
- Subcutaneous suture pulls nostril bases inward.
- No tissue removal.
- Reversible if needed.
- Less aggressive than excision.
- May lose effect over time.
How Korean surgeons decide
Alar base evaluation
- Width measured between nostril attachment points.
- Compared to inner-eye distance (rule of thirds).
- Symmetry assessed.
- Photographic documentation from multiple angles.
Flare evaluation
- Patient asked to smile.
- Nostril flare exaggerates with expression.
- Static vs. dynamic flare distinguished.
Combination assessment
- If flare only → wedge excision.
- If width only → sill excision.
- If both → combined technique.
- If subtle → cinched suture considered.
The procedure
- Local anesthesia.
- Markings made with patient sitting (gravity assessment).
- Conservative incisions placed in natural creases.
- Tissue removed with precision.
- Closure with fine sutures (6-0 nylon).
- 30–45 minutes total.
- Outpatient procedure.
Recovery timeline
First week
- Mild swelling.
- Sutures removed day 5–7.
- Avoid blowing nose.
- Sleep with head elevated.
- Antibiotic ointment to incisions.
Weeks 2–4
- Swelling mostly resolved.
- Scar pink in alar groove.
- Return to social activities.
- Avoid sun exposure to scar.
Months 1–6
- Scar gradually fading.
- Begin silicone gel application.
- Final shape established.
- Most scar maturation complete.
Pricing in Korean clinics 2026
- Standalone alarplasty: ₩1,200,000–₩2,500,000.
- Combined with rhinoplasty: typically included in rhinoplasty cost or +₩500,000–₩1,000,000.
- Premium surgeons higher.
- Outpatient procedure costs less than inpatient.
Combined with rhinoplasty
- Bridge augmentation alone may make nostrils appear smaller (proportional effect).
- True nostril width unchanged without alarplasty.
- Surgeon assesses whether bridge work alone will suffice.
- Many Korean rhinoplasty patients add alarplasty for complete reshape.
- Single surgical session.
Risks specific to alarplasty
- Visible scar — usually subtle in alar groove, but never invisible.
- Asymmetry — possible; revision considered.
- Hypertrophic scarring — managed with steroid or laser.
- Excessive narrowing — pinched appearance; difficult to revise.
- Functional changes — rare with conservative technique.
- Pigmentation changes — managed with sun protection.
Who is and isn\'t a good candidate
Good candidates
- Wide nostril base disproportionate to face.
- Persistent flare.
- Patients who\'ve had rhinoplasty without alar work and want completion.
- Stable preference.
- Realistic expectations about scar.
Less ideal candidates
- Already-narrow nostrils.
- Tendency to keloid scarring.
- Active facial inflammation.
- Patients pursuing dramatic transformation incompatible with anatomy.
What patients should know
- Permanent procedure.
- External scar inevitable with wedge technique.
- Internal scar (sill technique) hidden but reduction may be subtler.
- Conservative reduction preferred.
- Final scar varies by individual healing.
- Sun protection critical.
What doesn\'t work
- "Nostril reducing" exercises (no real effect).
- Topical creams claiming to reduce nostril width.
- Mechanical clip-style devices (not effective long-term).
- Filler placement to attempt nostril narrowing.
The Korean approach
Korean alarplasty practice emphasizes proportionality — the goal is harmony with the rest of the face, not maximum reduction. Korean surgeons typically perform conservative reductions that look natural at rest and during expression, accepting that subtle scars in alar grooves are an acceptable trade-off for permanent shape improvement. The technique is often combined with bridge work for complete reshape, though it can be performed standalone for patients with otherwise satisfactory nasal bridges.
The honest framing
Alarplasty is one of the more straightforward minor cosmetic procedures, but it produces permanent change that\'s difficult to revise. The patients who get good outcomes are those whose nostril width genuinely warrants reduction, who choose surgeons with demonstrated alarplasty experience, and who accept that a faint scar in the alar groove is the trade-off for permanent narrowing. The patients who pursue alarplasty for marginal width improvements often find the scar more visible than the improvement; the patients with pronounced flare or width get meaningful, durable improvement. Match the technique to the indication, choose conservatively, and protect the scar during healing.