Plastic Guide for Nasal Alae Cartilage Folding Surgery in New York City 2025

Introduction

New York City stands as a global hub for plastic surgery, offering a plethora of options for those seeking to enhance their appearance, especially in the realm of nasal procedures. Nasal alae cartilage folding surgery is a specialized procedure that can bring about significant aesthetic and sometimes functional improvements. In this comprehensive guide, we will delve deep into the world of nasal plastic surgery in New York City, with a particular focus on nasal alae cartilage folding surgery, along with related procedures such as nasolabial fold surgery, nasal base reduction, and alarplasty.

Understanding Nasal Anatomy

Before we explore the specific surgeries, it's essential to have a basic understanding of nasal anatomy. The nose is a complex structure composed of bone, cartilage, and soft tissue. The nasal alae are the lateral parts of the nose that form the sides of the nostrils. They play a crucial role in the overall appearance and function of the nose. The nasal base, which is formed by the area between the nostrils, also contributes to the nose's overall shape and proportion. Additionally, the nasolabial folds, which run from the bottom of the nose to the corners of the mouth, are an important aspect of facial aesthetics.

The width of the nasal base can be measured from the outer margin of one nostril to the outer margin of the opposite nostril, and its axis can be classified as vertical, divergent, or convergent. Generally, the nasal base should fall between the distance between the inner corners of a patient's two eyes. Knowledge of the nasal base anatomy, including the columella, nasal sill, and the relationship between various structural elements, is essential for determining the optimal surgical technique for nasal procedures.

Nasolabial Fold Surgery

What are Nasolabial Folds?

Nasolabial folds are the lines that run from the bottom of the nose to the corners of the mouth and are sometimes referred to as “smile lines.” These structures in the face support the buccal fat pad and separate the cheeks from the upper lip. Everyone has nasolabial folds to some degree, but their prominence can vary among individuals.

Causes of Deep Nasolabial Folds

• Age: As we age, the collagen and elastin fibers in our skin break down, causing the skin to lose its elasticity and firmness. This, along with the flattening of the cheekbones and sagging of the skin, can lead to deeper nasolabial folds.
• Sun Damage: Exposure to the sun's harmful UV rays can accelerate the breakdown of collagen and elastin, contributing to the development of deep nasolabial folds.
• Smoking: Smoking is known to have a detrimental effect on the skin. It can reduce blood flow to the skin, making it thinner and less elastic, and increasing the likelihood of deep nasolabial folds.
• Weight Changes: Significant weight loss can result in looser skin in the face and neck, while significant weight gain can plump up the face and accentuate the creases.
• Genetic Factors: Some people may be genetically predisposed to having deeper nasolabial folds, even at a young age. For example, genetic factors can cause deepened nasolabial folds in people as young as 25.

Prevention of Nasolabial Folds

While it's impossible to completely prevent nasolabial folds, there are steps you can take to minimize their appearance. Abstaining from smoking and using sunscreen regularly are the best steps you can take toward a youthful countenance. Moisturizing skin care products with vitamin C and retinol can also help keep the skin supple and smooth.

Treatment Options for Nasolabial Folds

There are both non - surgical and surgical options available for treating nasolabial folds.

Non - Surgical Options

• Dermal Fillers: Dermal fillers such as Restylane and Juvederm can be injected into the nasolabial folds to add volume and reduce their appearance. These fillers can provide immediate results that typically last for up to 18 months.
• Laser Skin Resurfacing: Laser skin resurfacing uses laser technology to remove the outer layer of skin, stimulating the production of new collagen and improving the texture and appearance of the skin. It can be effective in reducing the appearance of nasolabial folds.
• Microdermabrasion: Microdermabrasion is a non - invasive procedure that uses tiny crystals to exfoliate the skin, removing dead skin cells and promoting the growth of new skin. It can help improve the appearance of nasolabial folds to some extent.

Surgical Option: Nasolabial Fold Excision

When the folds are deep and longer - lasting results are desired, nasolabial fold excision may be recommended. This procedure is typically performed under local anesthesia and takes about an hour. The surgeon makes an incision in the natural crease line and removes the excess skin and tissue. The stitches are removed within five to seven days, and it may take several weeks for the full recovery to occur. This procedure is best for people who have severe/heavy creases that would not respond well to fillers.

Cost of Nasolabial Fold Surgery

The cost of nasolabial fold surgery varies depending on several factors, including the facility, geographic location, type of anesthesia, and expertise of the surgeon. Generally speaking, it's 50 - 75% cheaper than a facelift and less invasive as well. This cosmetic procedure is not covered by health insurance providers, but many surgeons offer payment plans and financing options.

Nasal Base Reduction

What is Nasal Base Reduction?

Nasal base reduction, or alarplasty, refers to a rhinoplasty technique that is intended to narrow the alar base, or base, of the nose in cases where it is excessively wide for the face. The alar base plays a central role in the overall proportion and appearance of the nose and the nose's harmony with the rest of the face. An overly flared or wide alar base can lead to a nose that looks bottom - heavy.

Benefits of Nasal Base Reduction Surgery

• Refines the Nose: It helps to refine and improve the overall appearance of the nose, making it more in proportion with the rest of the face.
• Improves Facial Symmetry and Balance: By narrowing the nasal base, it can enhance the symmetry and balance of the face.
• Boosts Self - Confidence: A more aesthetically pleasing nose can improve self - confidence.
• Decreases Nostril Size: It reduces the size of the nostrils and may also reduce nostril flare.
• Provides Long - Lasting Results: The results of nasal base reduction surgery are long - lasting.

Anatomy Involved in Nasal Base Reduction

Knowledge of the nasal base anatomy is essential for determining the optimal surgical technique. The nostrils are separated into right and left sides by the columella, the vertical “column - like” structure that runs down the center of the nose. The nasal sill extends from either side of the bottom of the columella and extends to the alar base insertion, or the segment of the nostril side wall where it meets the cheek - upper lip junction. In evaluating the shape of the nostrils from the base, the anterior nasal spine, lower lateral cartilages, caudal septum, maxilla, upper lip, and the soft tissue and skin that envelope the nose are all contributing factors in the overall appearance of the nasal base and its width.

Surgical Techniques for Nasal Base Reduction

1. Alar Wedge Excision: Also known as the weir incision, this is the preferred technique for minimizing ala that are excessively flared to reduce wide nasal base from the frontal appearance. The wedge excision technique removes wedge - shaped pieces of tissue from the nasal flare, and spares an incision in the nostrils. It is ideal for avoiding an over - straightening of the ala, preserves the natural curvature of the ala, and has the added benefit of avoiding telltale incisions in the opening of each nostril.
2. Nasal Sill Excision: This is typically used in the correction of enlarged nasal sill width along with excessive flare in the ala. Sill reduction is indicated when the nasal base has a horizontal axis and the nostrils are enlarged. The sill alone is directly narrowed when the alar base is wide because of a large nasal sill and presents no flaring, however this is very rare.
3. V - Y Advancement: This technique is used to reposition the alar insertion if the lateral insertion of the ala is responsible for excessive nasal base width. However, it is rarely performed as it will leave a scar on the face.

Candidates for Nasal Base Reduction Surgery

Candidates for nasal base reduction are individuals who have concerns with the excessive width of the base of their nose. They should be in good general health and have realistic expectations about the results of the surgery.

Risks and Recovery

Nasal base reduction is a fairly common procedure with minimal risks when working with an experienced surgeon. If performed alone (without concomitant rhinoplasty), it can be performed under local anesthesia only. Recovery time for nasal base reduction is roughly one to two weeks. Patients can expect that the base of their nose will be slightly swollen and red immediately following surgery, but this will subside gradually over the recovery period. Any stitches are typically removed one week after surgery. Full recovery takes approximately one month. Although rare, risks can include infection, bleeding, and scarring.

Alarplasty

What is Alarplasty?

Alarplasty, also known as nostril or alar reduction surgery or alar trimming, is a cosmetic procedure that allows for minor modifications to the width and shape of the nostrils. It is a part of rhinoplasty and is suitable for those who are happy with their nose shape and only want to adjust their nostrils. A nicely shaped nose features nostrils proportionate to the nose's total size, and alarplasty can help achieve that by altering the width and shape of the nostrils with a minor incision to the sides of the alae.

Benefits of Alarplasty

• Narrow the Nose: It can narrow the nose to suit the face, improving its overall appearance.
• Adjust Nostril Asymmetry: Alarplasty can correct nostril asymmetry, making the nose more symmetrical.
• Improve Nasal Blockage: In some cases, it can improve nasal blockage and help with breathing.
• Boost Self - Esteem: By enhancing the appearance of the nose, it can boost self - esteem.

How is Alarplasty Performed?

Generally, the surgeon makes an incision to remove a nasal wall wedge along the alar crease, so any scars following alarplasty are concealed within the nose's natural folds. The exact technique may vary depending on the shape and objective of the procedure.

Cost and Recovery

The cost of alarplasty in New York City can range from $6,000 to $9,000, but this can vary depending on factors such as the patient's aesthetic goals, the length and involvement of the surgery, anesthesia and facility fees, and the surgeon's experience. Recovery time is relatively quick. Unlike a typical rhinoplasty procedure, no cartilage or bone is removed in an alarplasty. Any swelling, bruising, and tenderness will be resolved within 1 - 2 weeks, and stitches will be removed around the same time. Most patients can resume their normal activities within one week, but strenuous activities must be avoided for 2 - 3 weeks after surgery. Full recovery from alarplasty typically takes 1 - 3 months.

Nasal Implants in Rhinoplasty

When are Nasal Implants Used?

When the nose needs cosmetic plastic surgery enhancement (e.g., to augment & define a flat nose) or functional improvement (to give structural support to tissues destroyed by a previous nose job surgery, trauma, or genetic irregularity), an implant may be the answer. Implants are derived from synthetic material or from donated and banked biological material and are not to be confused with grafts, which herald from natural cartilage, skin, mucous membrane, or muscle.

Types of Nasal Implants

• Synthetic Implants: Made from materials such as silicone and Gore - Tex®, these are inert and therefore ignored by the body. Others like Medpor integrate with the body, similar to an artificial hip, knee, or shoulder joint. They have the advantage of not getting reabsorbed over time and not changing shape or breaking down.
• Biologically Sourced Implants: These include rib cartilage and Alloderm, which comes from harvested cadaver skin that has had all of the cells stripped out of it so the patient's own cells and blood vessels can grow into it. Biologically sourced implants are available in unlimited amounts.

Procedure and Recovery

Rhinoplasty or nose job surgery with implants or grafts can be performed in an office - based surgical facility or in a hospital, under local anesthetic with IV sedation or under general anesthesia. This plastic surgery procedure takes between 45 minutes and two hours. Most of the time, all incisions are made internally and there are no visible scars. Sometimes, an incision is made at the base of the nostrils and the incision is carefully hidden. You can return to work in about a week after your cosmetic nasal plastic surgery and you'll be able to use a stationary bike or treadmill by the second week. By the third week, you can return to full activities. Although you'll see immediate improvement, your nose's shape and your profile will continue to refine over the next 12 to 18 months.

Risks

Like all cosmetic plastic surgery, rhinoplasty with grafts and or implants has certain risks including infection, bleeding, and reaction to anesthesia. Other risks include structural damage to the nose and the possibility that the implant might shift. In some cases, synthetic implants that integrate with the surrounding tissue may be difficult to remove on an elective basis.

Rhinoplasty (Nose Job)

What is Rhinoplasty?

Commonly known as a “nose job,” rhinoplasty is one of the most common cosmetic surgeries performed in the U.S. It changes the shape of the nose by modifying the bone and cartilage of the nasal framework. After accessing the framework through carefully concealed incisions, the bone of the upper portion of the nose is sculpted and smoothed. The cartilage in the lower portion of the nasal framework is then carefully reshaped in order to bring all the dimensions of the nose into harmony. The nasal septum is straightened and reshaped to improve breathing. Any necessary grafts are used to support and contour the final result.

Types of Rhinoplasty Procedures

Primary Rhinoplasty

This surgery is performed for the first time to address cosmetic concerns and/or nasal breathing. It aims to correct issues such as a crooked nose, a large nose, or a dorsal hump, and can also improve breathing problems.

Revision Rhinoplasty

This procedure is performed to address concerns or deformities resulting from prior nose surgeries. It is often more complex than primary rhinoplasty and requires a highly skilled surgeon.

Open and Closed Rhinoplasty Techniques

Closed (Endonasal) Rhinoplasty

During this closed surgical approach, all of the incisions are made inside the nose. The advantage of this approach is the lack of an external scar and the relatively shorter duration of the operation. However, it may be more limited in terms of the changes that can be made to the nose.

Open (External) Rhinoplasty

In this open approach, a small incision is added at the base of the nose to increase the surgical field of vision. This approach allows for better visualization of the nasal anatomy and more complex alterations and grafting to be performed. However, it causes more swelling after surgery, has a longer recovery time, and there is a chance of additional scarring.

Multidisciplinary Approach and Combining Procedures

At some medical facilities in New York City, patients have access to a multidisciplinary approach. For patients with specific concerns related to their nasal breathing, nasal allergies, sinus disease or deformity after cancer treatments, the surgeons work closely with experts in the division of rhinology and sinus surgery and the head and neck institute. They can even perform combined surgeries when appropriate. Some patients who have rhinoplasty for cosmetic improvements may also benefit from cheek