Background: Although alar base reduction can be beneficial for Asians, potential complications may arise following this procedure, including hypertrophic scarring, asymmetry of the nostrils, notching, loss of alar creases, and nasal obstruction. In some cases, revision surgery is required to address these issues.
Objective: Achieving optimal results with alar base reduction requires careful consideration of potential complications, as well as the overall benefits for the patient. Surgeons must carefully evaluate factors, such as alar flaring, nostril width, and lateral alar length, to ensure that modifications are appropriate and effective.
Methods: This study included 41 patients (19 males, 22 females; mean age: 25.3 years; range: 17–45 years) who underwent alar base reduction between January 2016 and December 2022. The mean observation period was 8.3 months (range: 6–14 months).
Results: The degree of visible scarring was unnoticeable in 31 patients (75.6%), noticeable but acceptable in 9 (22.0%), and noticeable and unacceptable in 1 (2.4%). The degree of scar using the modified Stony Brook Scar Evaluation Scale scores was 5.32±0.690 for type 1 and 5.25±0.775 for type 2. Asymmetry was observed in 32 patients (78.0%). Notching of the nasal sill was observed in one patient (2.4%), and blunting of the alar crease was observed in two (4.9%). No patient required revision surgery.
Conclusion: Although alar base reduction in Asians provided satisfactory cosmetic results, a special care is required to prevent complications such as nostril asymmetry and hypertrophic scars.

Keywords: alar base, complications, rhinoplasty, scar

1. Choi JY. Alar base reduction and alar-columellar relationship. Facial Plast Surg Clin North Am 2018;26:367-75.
   
2. Rohrich RJ, Savetsky IL, Suszynski TM, Mohan R, Avashia YJ. Systematic surgical approach to alar base surgery in rhinoplasty. Plast Reconstr Surg 2020;146:1259-67.
   
3. Singer AJ, Arora B, Dagum A, Valentine S, Hollander JE. Development and validation of a novel scar evaluation scale. Plast Reconstr Surg 2007;120:1892-7.
   
4. Hudise JY, Aldhabaan SA, Nassar RS, Alarfaj AM. Evaluation of scar outcome after alar base reduction using different surgical approaches. J Oral Maxillofac Surg 2020;78:2299.e1-8.
   
5. Yu BF, Li SQ, Chen XX, Wei J, Dai CC. Correcting wide alar base and flare with combined sill and alar excision in asian patients. J Craniofac Surg 2021;32:e754-7.
   
6. Lima LF, Arroyo HH, Jurado JR. Update in alar base reduction in rhinoplasty. Curr Opin Otolaryngol Head Neck Surg 2016; 24:316-21.
   
7. Kim JH, Park JP, Jang YJ. Aesthetic outcomes of alar base resection in Asian patients undergoing rhinoplasty. JAMA Facial Plast Surg 2016;18:462-6.
   
8. Carniol ET, Adamson PA. Surgical tips for the management of the wide nasal base. Facial Plast Surg 2018;34:29-35.