Condition
Alar Retraction After Rhinoplasty
Alar retraction is an upward-pulled nostril rim after rhinoplasty that can show excess nostril. Causes, the link to external valve support, and graft repair options.
ABFPRS
Facial Plastic & Reconstructive Surgery
ABOto
Otolaryngology — Head & Neck Surgery
AAFPRS
Fellowship Director
Overview
Alar retraction is a nostril rim that sits too high after rhinoplasty, often exposing more nostril than desired. Because the rim is both highly visible and scar-sensitive, repair calls for careful, structural correction.
Medically reviewed by Moustafa Mourad, MD, FACS — dual board-certified Facial Plastic & Reconstructive Surgeon and Otolaryngologist (Head & Neck Surgery).
Last reviewed: June 2026
Key takeaways
- Alar retraction is an upward-pulled nostril rim that can expose excess nostril.
- Causes include cartilage over-resection, scar contraction, weak cartilage, or anatomy.
- It can be purely cosmetic or contribute to external valve weakness.
- Repair may use alar rim, composite, or lateral crural strut grafts.
- Because the rim is highly visible and scar-sensitive, correction is delicate.
An Established Academic Authority
Double board certification. Fellowship director. Published author. A surgeon's surgeon.
ABFPRS
Board Certified
American Board of Facial Plastic & Reconstructive Surgery
ABOto
Board Certified
American Board of Otolaryngology — Head & Neck Surgery
AAFPRS
Fellowship Director
American Academy of Facial Plastic and Reconstructive Surgery
Textbook
Published Author
Contributions to the academic literature of facial plastic surgery
Dual board certification in both Facial Plastic & Reconstructive Surgery and Otolaryngology — Head & Neck Surgery.
Castle Connolly Top Doctor — Plastic Surgery, 2026What alar retraction is
Alar retraction occurs when the nostril rim sits too high or pulls upward, often exposing more of the nostril than a patient would like. It changes the balance of the nostril and tip and can make the nose look operated, particularly on profile and three-quarter views.
Causes
It may result from over-resection of the lower lateral cartilage during a prior operation, scar contraction pulling the rim upward, inherently weak cartilage, or natural anatomy. After rhinoplasty, scar and loss of support are the more common drivers.
Functional impact
In some patients alar retraction is purely cosmetic. In others, the same loss of rim support contributes to external nasal valve weakness or collapse, which can affect breathing. Where the airway is involved, it is addressed alongside the cosmetic concern — see nasal valve collapse treatment.
Treatment
Treatment is structural and may include alar rim grafts, composite grafts (cartilage with skin or lining), lateral crural strut grafts, or broader revision rhinoplasty to lower and support the rim. Graft material may come from the septum, ear, or rib cartilage depending on availability and the degree of correction needed.
Expectations
Correction can be delicate because the nostril rim is highly visible and scar-sensitive, and the amount of movement achievable is finite. Realistic goals are important. To discuss repair, see the revision rhinoplasty page or schedule a consultation.
Frequently Asked
Alar Retraction After Rhinoplasty — patient questions, honestly answered.
It often results from over-resection of the lower lateral cartilage during a prior operation, scar contraction pulling the rim upward, weak cartilage, or natural anatomy. After surgery, scar and loss of rim support are the more common causes.
Sometimes. In many patients it is a cosmetic concern that exposes more nostril than desired. In others, the same loss of rim support contributes to external nasal valve weakness or collapse, which can affect breathing and is addressed at the same time.
Correction is structural and may use alar rim grafts, composite grafts, lateral crural strut grafts, or broader revision rhinoplasty to lower and support the rim. The graft source depends on availability and the degree of correction needed.
Correction can be delicate because the rim is highly visible and scar-sensitive, and the achievable movement is finite. A realistic plan is set after examination, balancing appearance and, where relevant, breathing.
Continue exploring
Related rhinoplasty resources
Revision Rhinoplasty
Lowering and supporting the nostril rim after prior surgery.
Pinched Nose After Rhinoplasty
A related loss of tip and rim support.
Nasal Valve Collapse Treatment
Addressing external valve weakness when present.
Rib Cartilage Revision Rhinoplasty
Grafting options for rim reconstruction.
Schedule a consultation
Have alar retraction evaluated by Dr. Mourad.
Next step
Plans are individualized. The consultation is where that begins.
Reach the Manhattan office to schedule a private consultation with Dr. Mourad.