Alar trimming/ Alar Plasty
To better evaluate the nose, this is divided into 3 general parts or region, the nasal dorsum or bony bridge, nasal tip and ala or alar lobule. The type of cosmetic enhancement procedure of the nose that a patient will need varies and depends on the area of the nose that is of great concern to the patient.
For Caucasians that have a dorsal hump or crooked nasal dorsum, they would need infracture rhinoplasty to straighten and smoothen the bridge of their nose. While for a drooping nasal tip, they will need a tip plasty to increase their tip projection.
However for Asians, rhinoplasty is a more challenging procedure. There are numerous features of the Asian nose that may need correction or enhancement with rhinoplasty. Very common among Asians is a low nasal bridge because of a less prominent or not fully developed nasal bone. This can be enhanced with augmentation rhinoplasty. This is performed by inserting a nasal implant, either silicon or gortex, through an incision inside the nose. The nasal implant is inserted into a pocket created under the skin and on top of the bony bridge. This will increase the height of the bony bridge or dorsum of the nose.
A round or bulbous nasal tip, which is also a common feature of an Asian nose is due to a well develop and large cartilage at the nasal tip. This cartilage widens the tip of the nose and making it less defined. This is corrected with tip plasty procedure that excises the excess cartilage at the tip of the nose. With this, the tip will narrow down and will have more definition. Tip plasty also increases the projection of the nasal tip, which is very much needed in Asian nose because of the deficiency in height at the nasal tip.
For the alar region of the nose, ideally the width of the alar base should not go beyond the medial end of the eyes. And an aesthetically appealing nose when viewed from the side, the collumela of the nose should be exposed and not covered by an overhanging alar rim. It is very common among Asians to have a thick and overhanging alar rim with a wide and flaring alar base. This can be enhanced by alar trimming surgery, this procedure narrow down the alar width of the nose and remove the excess or overhanging alar rim, thus exposing the collumela.
This is frequently requested by oriental patients. Asians usually have wide, round nasal tip with overhang of the alar lobule area. Alar trimming are commonly performed on patient with wide nostril and flaring alar lobule. This procedure will improve the contour and definition of your nasal alar lobule area. This is done, either under local anesthesia or intravenous sedation depending on the preference and comfortability of the surgeon and the patient. The procedure last for 45 to 60 minutes, and done as an out patient procedure. There is minimal swelling after the procedure that usually subsides after 1 to 3 weeks. Sutures are removed on the 3rd to 4th day post operatively.
Individuals planning to undergo alar trimming are prepared prior to scheduled surgery. Patients are advised to avoid the following for 2 to 3 weeks before surgery; smoking, alcoholic beverages, steroids, NSAIDs or pain medications like mefenamic acids and naproxen, herbal tea, herbal medications, Vitamin E, blood thinning medications like aspirin, heparin and coumadin, regulated drugs like valum, prohibited drugs like methamphetamines, diet pills and oral contraceptive pills. These medications and social activity may delay healing, prolong bleeding during surgery and may interact with the medications used during surgery. It is advised that patients discuss this further with their surgeon to minimize possible risks and complications.
Prospective patients planning to have this procedure are required to allot 12 to 14 days. This time will be used for the initial consultation, laboratory, medical clearance, surgery, follow up, suture removal and early recuperation. After this patient is safe to travel since wounds are dry and healed.
Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.
The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another surgery may be necessary.
The decision to have a tummy tuck is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.
Possible risks and complications:
• Infection
• Poor wound healing
• Anesthesia risks
• Bleeding (hematoma)
• Nose asymmetry
• Change in skin sensation (numbness)
• Pain, which may persist
• Unfavorable scarring
• Skin contour irregularities
• Skin discoloration and swelling
• Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
• Possibility of revision surgery
For more information you may visit www.cosmeticphilippines.com or www.philcosmeticplasticsurgery.com
Author:
Dr Rino Lorenzo is a Filipino Plastic Cosmetic and Reconstructive Surgeon based in Manila, Philippines. He is a Board Certified and fully trained Cosmetic Plastic Surgeon, with 6 years of formal training in the field of Aesthetic, Reconstructive and Burn Plastic Surgery. Dr Rino Lorenzo is a Fellow of the Philippine Association of Plastic Reconstructive and Aesthetic Surgeons.
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