Q: At a recent Rhinoplasty consultation I was told that an alar base reduction could not be performed at the same time as the initial Rhinoplasty as it would be to difficult to make the correct alterations. If a reduction was needed I would have to wait until all swelling from my initial surgery subsided. Is this the common method?
Dr. A’s Answer: The surgeon who told you that seems to have a preference for not doing nasal base reduction during the rhinoplasty. However, for the surgeon to say “could not be performed” is not at all true. The decision to do an alar base reduction is typically made pre-operatively as I study the patient’s nose and discuss the result the patient would like to achieve. If there is any doubt, certainly you can leave that part of the procedure to a later date. Because there is typically no bruising and because it can be done using only local anesthesia in about 10 minutes, it is reasonable to do the base reduction later. But ideally, you would determine the need for this pre-operatively and perform it simultaneous to the rest of the surgery for most efficient use of patient healing time and to improve patient comfort.