Abstract The alar base plays a crucial role in nasal symmetry and esthetic balance. Various surgical techniques have been developed to address deformities or asymmetries in this region, yet no comprehensive synthesis has been performed to compare their clinical effectiveness across different contexts. The objective of the study is to systematically review and synthesize published clinical evidence on surgical techniques for alar base modification. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic databases (PubMed, Scopus, and Google Scholar) were searched in April 2025 for studies published between January 2000 and April 2025. Studies were included if they described clinical outcomes of surgical alar base modification techniques in humans. Quality assessment was performed using the Newcastle–Ottawa Scale. Twenty-seven studies were included. Fourteen studies assessed techniques in rhinoplasty. Frequently employed techniques included wedge excision, V-Y advancement, transalar suturing, and cinch sutures. Several studies reported favorable outcomes with newer flap designs and silicone splints. Quality scores were high for most prospective studies (≥7), while retrospective studies scored moderately (score 6). Alar base modification techniques show promising outcomes across various surgical fields. V-Y advancements and transalar sutures demonstrated consistent esthetic benefits with minimal complications. Further standardized research is needed to guide technique selection and optimize patient-specific outcomes.
Alshehri et al. (Wed,) studied this question.