2026-05-24
The Effect of Alar Lowering! (Correction of Upturned Nose)
This article details the correction of alar retraction, or an upturned nose, in a 20s female with a history of rhinoplasty. It covers the consultation, surgical plan using ear cartilage and skin, and post-operative results, emphasizing the limitations and benefits of alar lowering.
* Basic Information
# Female in her 20s
# History of nose surgery: 1 time (septum and silicone implant)
# Current condition and main complaint: ‘After nose surgery, my nostrils look pinched, like an upturned nose, and it's causing me stress.’
* Consultation
# This is ‘alar retraction,’ where the nostrils appear pinched. It needs correction because it gives a surgical and unnatural look.
# This is a difficult case to correct due to hardened scar tissue from the previous surgery.
# Since a significant amount needs to be corrected, we planned to lower it sufficiently using both skin and cartilage from the ear.
# If you are considering alar lowering, you must fully understand the following limitations before making a choice.
Limitations of Alar Lowering?!
1. 100% symmetry of the left and right nostrils is difficult to achieve.
2. The horizontal width may slightly increase after surgery.
3. The grafted cartilage may be slightly visible when viewed from below.
4. The touch may become a little firmer.
5. The area where ear cartilage was harvested may fold slightly. (However, it's usually unnoticeable to others)
* Plan
# Correction of upturned nose
: Alar (nostril) lowering (Right > Left)
* Post-operative Course
# Patient satisfaction is high because correction is possible relatively simply, without scars, and using only an incision inside the nostril.
# The surgical method varies depending on the degree of retraction. In mild cases, correction is possible with suture techniques of the lower lateral cartilage or cartilage grafting alone. However, for moderate to severe cases, cartilage grafting alone has limitations, so satisfactory correction requires grafting skin tissue as well.
# In this patient's case, a skin-cartilage composite graft was performed. To ensure that there is no change in ear shape or visible scarring after harvesting the graft, many factors must be considered during the design phase. Therefore, the graft was harvested from the innermost part of the ear to minimize visible scarring.
# The overall nose shape and impression became softer, and it was corrected symmetrically to a satisfactory degree.
For consultation and surgery, see a board-certified plastic surgeon!
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Yoo Young-moon, Chief Director of VIBE Plastic Surgery
VIBE Plastic Surgery complies with medical law.
The before and after photos were taken under identical conditions and with the patient's consent. Complications and side effects such as bleeding, inflammation, infection, and asymmetry may vary by individual after surgery and require caution.
Frequently Asked Questions
What are dragon nose and alar retraction?
Dragon nose refers to the phenomenon where the alar appears pinched, also known as alar retraction. This can make the nose look unnatural or obviously operated on after rhinoplasty, indicating a condition that requires correction.
Can alar retraction that occurred after nose surgery also be corrected?
Yes, it can be corrected. However, due to the hardened scar tissue from previous surgery, correction may be more difficult than in typical cases. In such cases, complex tissue grafting using both skin and cartilage from the ear may be necessary.
What materials are used for alar lowering surgery?
Mainly, cartilage and skin tissue from the ear are used together. Especially when a large amount needs to be corrected or in cases of moderate to severe retraction, cartilage grafting alone has limitations, so a skin-cartilage composite graft is performed to achieve satisfactory correction.
What are the limitations of alar lowering surgery?
Yes, there are a few limitations. 100% symmetry of the left and right nostrils may be difficult to achieve, the horizontal width may slightly widen after surgery, or the grafted cartilage may be slightly visible when viewed from below. Also, the touch may become a bit firm.
Will there be scars after alar lowering surgery?
No, because correction can be done relatively simply using only an incision inside the nostril, there are almost no visible scars. The area where cartilage is harvested from the ear is also taken from the innermost part to be inconspicuous.