“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
Pre-operative instructions, medical clearance when you have sedation, and a personalized plan Dr. Truesdale reviews with you before the day of the procedure.
Procedure Day
Performed at True Surgical Center, under local anesthesia or with MAC and IV sedation. 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 in Beverly Hills: the essentials
- Your surgeon
- Dr. Truesdale personally.
- Where
- True Surgical Center, the AAAHC-accredited surgical center at 150 S. Rodeo Drive, Suite 220, Beverly Hills.
- Anesthesia
- Local anesthesia alone, or local anesthesia with MAC (monitored anesthesia care) and IV sedation, given and watched throughout by a board-certified anesthesiologist. Dr. Truesdale decides with you.
- Time in surgery
- About 30 to 45 minutes on its own. Longer when it is part of a rhinoplasty.
- Sutures
- Dissolvable sutures dissolve within about 2 weeks; non-dissolvable sutures come out at your Day 5 visit with Dr. Truesdale.
- Going home
- Back to your hotel or home the same day. If you have sedation, an adult takes you and stays with you for the first 72 hours.
- If you travel
- Arrive at least a day before surgery and plan on about a week. Most patients fly home after their Day 5 visit, that day or the next.
- Glasses
- Nothing resting on the bridge of the nose for at least 2 weeks.
- Exercise
- Light cardio at 2 weeks; heavier exercise at about 3 weeks, once Dr. Truesdale clears you.
- Final result
- Nostril width and shape settle over 1 to 3 months as the last swelling resolves.
The facts patients ask about first. Every plan is personal, so Dr. Truesdale confirms each of these for you at your consultation. Recovery, week by week
What happens on surgery day
Alarplasty narrows a wide nostril base or a flare, on its own or alongside a rhinoplasty. Here is what the day looks like for you.
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01Before you go in
Under local anesthesia alone you eat and drink normally that morning; if you are having sedation, nothing to eat or drink after midnight. Dr. Truesdale goes over the plan with you before you begin.
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02Measuring the width
Dr. Truesdale reads your nostril width against the tip of the nose and the rest of your face, and plans to refine only the width that is out of proportion, never narrowing the nostrils to a degree that looks small.
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03Small incisions in the natural crease
Through tiny incisions hidden in the natural crease where the nostril meets the cheek, a small, measured amount of tissue at the nostril base is removed to narrow the base or the flare.
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04Closing
Dr. Truesdale places and ties every suture himself. Depending on the sutures used, they dissolve on their own within about 2 weeks or come out at your Day 5 visit.
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05Going home
You go back to your hotel or home the same day, with Aquaphor on the incisions. Some nasal congestion, and swelling and bruising around the nose and mouth, are expected at first. When alarplasty is part of a rhinoplasty, it is done in the same operation.
Dr. Truesdale’s approach to rhinoplasty → · Rhinoplasty · Lip lift
Alarplasty recovery, week by week
This is the same protocol our patients receive in writing before surgery. The detailed instructions below come straight from it, so they change only when Dr. Truesdale changes them.
Swelling and bruising around the nose and mouth, and some nasal congestion. Ice 20 minutes on and 20 off for 5 days to a week, and sleep with your head raised on 2 to 3 pillows. Clean the incisions gently with a Q-tip, soap and water, then Aquaphor, several times a day. No big smiles, kissing or excessive mouth or nose movement, and no bending, lifting or straining. Regular diet, without excessive chewing. Non-dissolvable sutures come out at your Day 5 visit with Dr. Truesdale.
Swelling eases after about 6 days and keeps going down over 2 weeks. Most patients plan on 5 to 7 days before they feel ready to be seen. Makeup on the surrounding skin is fine, but keep it off the incisions for at least 10 days. No glasses resting on the bridge of the nose for at least 2 weeks. Light cardio from Day 14.
Heavier exercise at about 3 weeks, once Dr. Truesdale clears you. No hot showers or saunas for at least 1 month. SPF 50 and limited sun for 6 weeks.
Nostril width and shape settle as the last swelling resolves. Follow-ups at 1 week, 1 month and 3 months; the 3-month visit is your last scheduled one.
Your detailed instructions
Swelling and bruising around the nose and mouth area. Sutures at the base of the nose — dissolvable sutures dissolve within 2 weeks; non-dissolvable sutures are removed at your Day 5 visit with Dr. Truesdale. Some nasal congestion is expected. Ice 20 minutes on, 20 minutes off for 5 days to a week. Sleep with head elevated on 2–3 pillows. The incision will feel thick and lip motion will feel tight initially.
Gently clean the incision at the base of the nose with a Q-tip, soap, and water. Apply Aquaphor to the incision multiple times daily. Do not touch or pick at the incision site.
Post-op appointment with Dr. Truesdale; non-dissolvable sutures are removed if used.
Regular diet as tolerated; avoid excessive chewing. Light walking encouraged after 24 hours. Continue sleeping with head elevated.
Tension on lips and nose — no big smiles, kissing, or excessive mouth/nose movement. Bending, lifting, or straining. Resting glasses on the nasal bridge for at least 2 weeks.
Swelling persists ~6 days with gradual reduction over 2 weeks. Makeup OK on the surrounding skin, but avoid the incision site for at least 10 days. Continue Aquaphor or Vaseline on dry incision areas.
Light cardio — elliptical, spin bike, low resistance — may resume at two weeks, for every procedure. Confirm with your surgeon at your follow-up before increasing intensity. Heavy cardio, weightlifting, bending over, yoga, and Pilates typically resume at three weeks — once your surgeon clears you at a follow-up. Three weeks is a judgment, not a date that clears itself. Avoid hot showers and saunas for at least 1 month. Avoid sun exposure for 6 weeks; daily SPF 50+.
Full post-operative care guide · Preparing for surgery · Traveling for surgery
Alarplasty risks, and how we keep you safe
Every operation carries risk. Dr. Truesdale goes through the risks that apply to your plan at your consultation, and each one is written in the consent you read and sign. For an alarplasty (alar base excision), the consent lists:
- Visible Scars. Visible scars at the base of the nostrils are possible.
- Nostril Shape. Notching of the nostril rim, nostril asymmetry or over-narrowing of the nostrils is possible.
- Breathing. A change in breathing is possible.
- Upper Lip and Smile. Stiffness of the upper lip or a change in the smile is possible while healing.
Risks of any operation
- Bleeding. Bleeding during or after surgery is possible. A collection of blood under the skin (hematoma) may need drainage or a return to the operating room, and severe bleeding may need emergency treatment or a blood transfusion.
- Infection. Infection is possible and may need antibiotics, drainage or further surgery.
- Bruising and Swelling. Bruising and swelling are expected. They may last several weeks, and swelling or discoloration may persist longer.
- Scarring. Every incision or entry point leaves a permanent scar. A scar may be raised, widened, darker, lighter or more visible than expected, and takes at least 3 months to mature.
- Keloid or Raised Scar. Itching, thickening, pain or a growth along any incision can be the first sign of a keloid (a thick, raised scar). Let us know right away so it can be injected with a steroid to stop the keloid from forming. A keloid is more likely if you have had one before and may need further injections or treatment.
- Change in Skin Sensation. Numbness, tingling or a change in skin sensation around the treated areas is possible; it may be temporary or permanent.
- Delayed Healing. Delayed healing or separation of an incision is possible and much more likely with nicotine in any form.
- Allergic Reactions. Allergic reactions to tape, sutures, skin cleansers, latex or medications are possible.
- Blood Clots. Blood clots in the legs or lungs (deep vein thrombosis or pulmonary embolism) are possible and more likely with longer surgery; your surgical team uses the clot-prevention plan chosen for you.
- Anesthesia. Risks of anesthesia and sedation are possible; the anesthesia provider reviews them with you separately.
- Pain. Pain after surgery is expected and should settle over several days; pain that lasts longer is possible.
- Result and Revision. A result that does not meet your expectations is possible: healing differs between people, no result is guaranteed, and a revision may be advised, with the fees described in your patient policy.
- Serious Complications. Serious complications, including death, are possible with any surgery or anesthesia.
- Heart and Lung Problems. Heart or lung problems, such as pneumonia or an irregular heartbeat, are possible after surgery and anesthesia.
- Medication Side Effects. Side effects of the medications used during and after surgery, such as nausea, vomiting, constipation, dizziness or trouble urinating, are possible.
- Injury to Deeper Structures. Injury to deeper structures, such as nerves, blood vessels, muscles or glands, is possible.
- Persistent Sutures. A deeper stitch may work its way to the surface and need to be removed.
How we keep you safe
- Surgery only at True Surgical Center, an AAAHC-accredited surgical center, with a board-certified anesthesiologist whenever sedation is used.
- Medical clearance, and blood-clot risk screening, before surgery with sedation. A procedure done under local anesthesia alone needs no labs or clearance.
- No nicotine in any form for 3 weeks before surgery and 3 months after.
- With sedation, someone with you for the first 72 hours.
- Your Day 5 visit with Dr. Truesdale, follow-ups at 1 and 3 months, and a direct line to the team the whole time.
When to call us right away · Before & after gallery · Dr. Truesdale’s approach to rhinoplasty · Request a consultation
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.
An alarplasty can be done under local anesthesia alone, or under local anesthesia with MAC and IV sedation; Dr. Truesdale decides with you. When sedation is used, 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.
It depends on the sutures Dr. Truesdale uses. Dissolvable sutures dissolve on their own within about 2 weeks. Non-dissolvable sutures come out at your Day 5 visit with Dr. Truesdale.
Keep glasses from resting on the bridge of your nose for at least 2 weeks after surgery. Ask us at your Day 5 visit if you are unsure what is safe to wear.
Arrive at least a day before surgery and plan on about a week. Your Day 5 visit is with Dr. Truesdale, and most patients fly home that day or the next. See traveling for surgery for hotels and aftercare.
Clean them gently with a Q-tip, soap and water, then apply Aquaphor several times a day; don’t touch or pick at them. Keep makeup off the incisions for at least 10 days, avoid hot showers and saunas for at least a month, and use SPF 50 and limit sun for 6 weeks. If you notice thickness, pain or itching at a scar, call us: an early steroid injection helps prevent a keloid.
The consent you sign lists these possible complications: visible scars at the base of the nostrils; notching of the nostril rim, nostrils that are not symmetrical or are narrowed too much; a change in breathing; and stiffness of the upper lip or a change in the smile while healing. It also lists the risks of any operation, including bleeding, infection, blood clots and the risks of anesthesia. Dr. Truesdale reviews each one with you. See alarplasty risks and safety.
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).