Managing Alar Flare in Rhinoplasty

Overview

Alar flare, the outward curve of the nostril walls, widens the lower third of the nose. Reducing it can improve balance but is hard to undo if overdone. This technique paper sets out when reduction is appropriate, how flare interacts with tip projection changes, and a three-type classification guiding the excision design. No patient series is reported; Level of Evidence V.

Sections of note

• Alar flare is distinguished from alar base width; the alar lobule has diverse shapes.
• Flare changes dynamically with tip projection: raising the tip reduces flare, lowering it increases flare.
• Three flare types are defined by alar rim shape on basal view.
• Excision pattern is tailored to flare type to avoid an "operated appearance."

What it means for a patient

• Wide nostrils may be flare (curved walls) or a wide base (far-apart insertions); they are treated differently.
• If the tip is being raised, flare may improve without any nostril cut, so flare surgery is often decided at the end of the operation.
• Over-resection is permanent and visible; conservative design matters.

Why this paper matters

It is a widely cited classification from the Dallas group for a step that is often done without a system. Limits: expert technique paper, no outcomes.

Terms

• Alar flare: outward bowing of the nostril side walls beyond the alar base.
• Alar lobule: the fleshy nostril wall.
• Basal view: the photograph taken from below the nose.
• Alar base resection (Weir excision): removing a wedge at the nostril base to narrow it.