Sequential Alar Base Resection in Primary and Secondary Rhinoplasty

Pozzi M, Susini P, Losco L, Bolletta A, Cigna E, Roxo CW.

What this paper says

A two-step nostril-narrowing method used in 423 patients in Rio de Janeiro produced satisfactory ROE scores, improved base symmetry and no technique-specific complications.

Overview

Wide or asymmetric nostrils are a frequent concern in ethnic rhinoplasty, and alar base cuts are nearly irreversible. The authors describe Sequential Alar Base Resection (SABR), which removes tissue in two sequential steps so the second cut can be tailored to what the first achieved. They retrospectively reviewed patients treated January 2019 to August 2023 and recorded satisfaction with the ROE questionnaire.

Sections of note

423 patients included.
Mean postoperative ROE indicated satisfactory nasal contour.
All patients improved in symmetry and harmony of the nasal base.
No SABR-specific complications; minimal morbidity at the resection site.
The stated aim is customised, symmetric reduction while "respecting the ethnic identity."

What it means for a patient

Nostril narrowing can be done in stages within one operation so the surgeon can match both sides before committing.
In this large series the scars and complications were minimal.
Numeric ROE values and follow-up length are not given in the abstract.

Why this paper matters

It is a large series of alar base surgery, a step with a reputation for visible scars and notching, from a high-volume Brazilian practice. Limits: retrospective, single centre, no comparison with standard resection, no quantified results in the abstract.

Terms

Alar base: where the nostril wall meets the cheek and lip.
Alar base resection: removing a wedge of nostril tissue to narrow the base (also called Weir excision).
Ethnic rhinoplasty: surgery that refines the nose while keeping features typical of the patient's heritage.
ROE: Rhinoplasty Outcome Evaluation satisfaction questionnaire.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“Ethnic rhinoplasty is a historical challenge for plastic surgeons, particularly when dealing with wide and asymmetric alar base and nostrils. The aim of this article is to describe our personal alar base resection technique, the Sequential Alar Base Resection (SABR), to increase the possibilities of symmetric and…”

Excerpt; the full abstract is on PubMed.