American Academy of Facial Plastic and Reconstructive Surgery

Permanent Dome Sutures

How effective is the use of permanent dome sutures for narrowing the nostrils?

This is less radical than alar base reduction and does not run the risk of asymmetries.

Please advise.

Good question. As a surgeon, I cannot provide my personal opinion here as I represent the Academy in a broad statement. I can say that some surgeons believe that the method is highly effective, whereas others believe that the method is short lived. Unfortunately, you will encounter variable thoughts in your research of the best method for alar base reduction. One way that I know of that helps to limit the unnatural shape of the alar rim is known as a “Sheen flap” that preserves the natural arc of the nose and is what I use when I do alar base reductions so that you don’t get that pinched look where you are missing the “nasal sill”, the part of the nostril that curves back onto the face or upper lip.