Evaluation of a Systematic Approach to Alar Rim Reduction for Overhanging Ala: A Quasi-Experimental Study in Lahore, Pakistan

Abstract

Background: Overhanging ala is a common aesthetic nasal concern that can disrupt alar contour and facial harmony, often requiring surgical correction. Various techniques for alar rim reduction have been described; however, a standardized, systematic approach remains lacking. The objective of this study was to evaluate the aesthetic outcomes of an alar rim reduction technique in patients with overhanging ala.
Methods: This quasi-experimental study was conducted over five months at Jinnah Burn and Reconstructive Surgery Centre, Allama Iqbal Medical College, Lahore and Cosmoplast Plastic Surgery Centre, Lahore. A total of 60 patients aged ≥18 years with clinically diagnosed overhanging ala undergoing alar rim reduction were enrolled through consecutive sampling. Patients unfit for anesthesia, with conditions affecting wound healing, unrealistic expectations, or unwilling to follow up, were excluded. All procedures were performed using a standardized mirror-image marking technique to ensure precise and reproducible alar rim correction. Patients were followed for 3 months postoperatively. Aesthetic outcomes were assessed using both objective (independent surgeon evaluation of nasal contour parameters) and subjective (patient satisfaction) measures on a 10 cm Visual Analog Scale (VAS), categorized as poor to excellent. Data were analyzed using SPSS version 25, with p <0.05 was considered as statistically significant.
Results: Mean age of patients was 28.9 years. The gender distribution of patients showed female predominance (65%). Mean satisfaction score for patients was 8.82 (excellent patient satisfaction: 96.7%). Mean VAS score for surgeons’ satisfaction was 9.31. Among more than 95% of patients, surgeons reported excellent outcomes across all measured parameters. Patient satisfaction and surgeons satisfaction showed no significant difference between age groups and the gender of patients.
Conclusion: This technique provides a safe, precise, and effective solution for correcting overhanging ala. Through the use of standardized markings and targeted soft-tissue excision, the technique ensures an ideal alar–columellar relationship.