Modified Rotation-Advancement Alar Flap Technique for Cosmetic Alar Reduction: Surgical Experience With 80 Asian Cases

Summary: Various surgical procedures were proposed for cosmetic alar reduction, but concerns including prominent scars and unnatural appearence remain. From January 2023 to January 2025, the author performed alar reduction using a modified rotation-advancement alar flap technique in 80 Asian patients. All 80 patients were followed up for 3–12 months (average 10.6 mo). Patients’ satisfaction was assessed with a questionnaire focusing on profile improvement and scar prominence. The modified rotation-advancement alar flap technique was shown to be less invasive. It simultaneously improved nostril show, flared alae, and bilateral symmetry, yielding a natural and aesthetic outcome in Asians.