“Alarplasty is one of the most elegant procedures in rhinoplasty — a small change in the right place that creates immediate, lasting harmony. The incision placement is critical: hidden in the natural alar-cheek crease, it heals to near-invisibility. My goal is always a result that looks proportionate and completely natural — refined, not reduced.”
What alarplasty can do for you
Alarplasty (nostril reduction) narrows the alar base with precision, producing permanent refinement of nostril width and flare. Most commonly performed alongside rhinoplasty, it can also stand alone as a conservative, focused correction.
- Proportionate nostril width — just enough refinement to balance the lower third of the nose to the rest of the face.
- No visible scar — the incision sits hidden in the natural crease where nostril meets cheek, fading over months.
- Works beautifully with a rhinoplasty — completes the lower-nose refinement that a tip rhinoplasty alone can’t address.
- Reads as natural from every angle — front, three-quarter, and profile views all softened in proportion.
- A 30-minute change that shifts the whole face — one of the smallest procedures with one of the largest proportional impacts.
Ready to discuss your alarplasty goals?
Understanding the alarplasty
What the alarplasty is
Alarplasty (nostril-base reduction) narrows a wide alar base with permanent, conservative refinement. Most commonly performed alongside rhinoplasty, it can also stand alone as a focused, subtle correction.
Who the alarplasty is for
If any of the following describes you, the alarplasty may be worth exploring:
What makes Dr. Truesdale’s approach different
Dr. Truesdale’s approach to every procedure reflects a consistent set of principles — the same standards that inform every consultation, every surgical plan, and every post-operative follow-up.
Restraint, Not Over-Correction
The most over-done procedures in facial aesthetics are over-done because someone kept going past the right stopping point. Dr. Truesdale's rule: when the result is right, stop — even if more could technically be done. For alarplasty, that means refining only the width that’s actually disproportionate — never narrowing nostrils to a degree that reads as small.
The Artist's Eye
Before becoming a surgeon, Dr. Truesdale was a trained portrait artist. That lens shapes every decision — proportion, light, shadow, the relationship between every feature — in a way purely clinical training alone does not. For alarplasty, that lens reads how nostril width relates to tip projection and overall facial proportions, not just the nose itself.
Personal, Start to Finish
Every consultation, every surgical plan, every procedure — performed personally by Dr. Truesdale. No delegation to coordinators, PAs, or residents. Dr. Truesdale is personally involved every step of the way. Every alarplasty incision and closure is placed and tied by Dr. Truesdale personally.
Natural Is Non-Negotiable
The only acceptable outcome is one that no one can identify as a procedure — a result that reads as a better version of you. No pulled look, no frozen expression, no obvious work. The alarplasty goal: nostrils in better balance with the rest of the face — no one looking can tell anything was done.
“A millimeter of alar base narrowing can transform the way a nose reads — over-narrowing destroys it.”
— Dr. Carl Truesdale, MD
Alarplasty before & afters
Real alarplasty patients of Dr. Truesdale. Every nostril refinement is designed in context of the face as a whole.
Your transformation starts with a conversation.
From first consultation to final reveal
We always tell our patients to ‘trust the process.’ You are in good hands on every step of the journey to your unique masterpiece.
Consultation
Personal session with Dr. Truesdale — facial analysis, honest assessment of candidacy, and a clear plan for what the procedure can and cannot achieve.
Planning
Medical clearance, pre-operative instructions, and a personalized plan Dr. Truesdale reviews with you before the day of the procedure.
Procedure Day
Performed in office under local anesthesia. Tiny incisions hidden within the natural nostril crease (alar–facial junction).
Suture Removal
Dissolvable sutures fall off on their own around 2 weeks; non-dissolvable sutures are removed at your Day 5 visit. Mild swelling for 1–2 weeks. Avoid resting glasses on the nasal bridge for at least 2 weeks. Avoid hot showers and saunas for 1 month. Avoid big smiles, kissing, or excessive mouth or nose movement. Makeup is OK on the surrounding skin but avoid the incision for 10 days.
Shape Settles
Nostril width and shape stabilizing as residual edema resolves.
Look and Feel Like a Masterpiece
Narrowed nostril base with a near-invisible scar at the alar crease.
Individual timelines vary. Dr. Truesdale sets realistic, patient-specific expectations during your consultation — not exaggerated claims.
See if an Alarplasty is right for you.
Meet Your Surgeon
Dr. Truesdale on technique, philosophy, and patient stories — from his self-produced Beyond the Surface docuseries and his educational content library.
Alarplasty FAQs
Bring your own questions to consultation — Dr. Truesdale personally answers every one. Below are the questions patients ask most often about alarplasty.
The strongest candidates have nasal base width or nostril flare that is out of proportion with the rest of the nose. Dr. Truesdale evaluates you personally in consultation and only recommends the procedure when it will genuinely help. If a different approach would serve you better, he’ll tell you that too.
Alarplasty addresses the base of the nose only. If your only concern is the width or flare of the alar base, alarplasty alone may be the right answer. If there are also concerns about the bridge, tip, or profile, a full rhinoplasty may be more appropriate. Dr. Truesdale often performs alarplasty concurrently with rhinoplasty to refine the entire nose in one procedure.
Most patients describe the discomfort as mild to moderate. The procedure is typically performed under local anesthesia with light sedation. Dr. Truesdale’s team is available throughout recovery — you are not managing discomfort on your own.
Our surgical procedures utilize a patient-focused anesthesia technique known as MAC (Monitored Anesthesia Care) and IV Sedation, ensuring your maximum comfort and safety. This method provides a level of gentle, deep sedation comparable to the comfortable experience many patients have during a colonoscopy, which we have found helps make patients less fearful. The anesthesia is administered intravenously and meticulously monitored by a hand-picked group of board-certified anesthesiologists, who are dedicated to your well-being throughout your entire procedure.
Plan on 5–7 days of social downtime. Expect sutures removed at day 5 with mild residual swelling. Light cardio resumes at 2 weeks; most patients are cleared for strenuous exercise at about three weeks, at a follow-up visit. Your follow-up appointments along the way are conducted by Dr. Truesdale and our physician assistant, with Dr. Truesdale seeing you personally at the key milestones.
That’s the entire standard Dr. Truesdale designs for. The change should be subtle and natural — not a visibly narrowed or pinched base. Every patient is evaluated in a seated, relaxed state beforehand so the target is based on your real anatomy — never on an idealized template.
Permanent. Alar-base reduction is a permanent skin-and-cartilage change.
Yes. A significant portion of Dr. Truesdale’s patients travel from across the United States and internationally. The process begins with a virtual consultation with Dr. Truesdale himself (not a coordinator), followed by in-person pre-procedure evaluation. Our patient-care coordinators help arrange travel, accommodations, and local transportation, and Dr. Truesdale’s team conducts virtual follow-ups after you return home.
Request a consultation through the form at the bottom of this page, email contact@doctortruesdale.com, or call (424) 363-4112. Our team responds within one business day to schedule either an in-person consultation at 150 S. Rodeo Drive, Suite 360, Beverly Hills, or a virtual consultation worldwide. Every consultation is conducted personally by Dr. Truesdale.
Alarplasty can be performed from age 16 onward (once the nose is fully developed). Most patients pursue it in their 20s and 30s as a standalone refinement or in combination with a full rhinoplasty.
The cost of alarplasty can vary based on the patient’s situation, including if it is a revision surgery and if this surgery will be combined with other surgeries or treatments. The total cost may include the surgeon’s fee, operating room fees, and anesthesia fees. At Truesdale Facial Plastic Surgery, we believe the surgeon’s philosophy and experience, and your comfort with him, are just as important as the final cost of the surgery. We can provide an approximate range for this procedure over the phone, and your patient care coordinator (PCC) will confirm the pricing for you after your consultation with Dr. Truesdale.
Schedule your alarplasty consultation
A conversation with Dr. Truesdale is the first step toward refined, proportionate nostril width that harmonizes with your face. We respond same-day, Monday-Friday.
Book a Surgical Discovery Call online
After clicking the booking link, select “new patient” under Schedule Your Appointment and fill out the form to see our current availability for a Surgical Discovery Call with a Patient Care Coordinator and book immediately. Call us (424) 363-4112 for additional appointment times and information.All times are based on Los Angeles, Pacific Time (PT).
Book Discovery Call →Prefer to share details first? Submit the form and a Patient Care Coordinator will reach out the same business day (Monday–Friday).