The Impact of Alar Base on Facial Features | Improvement Methods Available Through Cosmetic Medicine

Many people notice a hollow beside their nose or nasolabial folds every time they look in the mirror, and feel they look older than expected despite not having much sagging.

In fact, an area called the "alar base" (nasal alar base) may be involved in that impression.

This article explains the location and role of the alar base, its effect on facial appearance, the causes of recession, and the cosmetic medical treatments available to improve it.

What is the Alar Base?

The alar base is one of the foundations that supports the impression of the central part of the face.

First, we explain where exactly the alar base is located and how it differs from areas it is often confused with.

Location and Role of the Alar Base

The alar base refers to the area located at the base of the nostrils, around where the outer side of the alar meets the beginning of the nasolabial fold.

This area is shaped by the bone structure, including the maxilla, and the soft tissue that rests on top of it, serving as the foundation of the nasal tip.

It is the area that determines the three-dimensional appearance of the central face and the impression of the mouth area; its height and front-to-back position can affect the balance of the profile and the sense of depth of the face.

Areas Easily Confused with the Alar Base

An area often confused with the alar base is the "columellar base."

The columellar base refers to the underside of the columella—the pillar-shaped structure between the two nostrils—near the upper lip.

While the alar base is located at the root of the nostril wings, the columellar base is positioned closer to the center of the nose.

It can be difficult to determine by appearance alone which area is of concern, so we recommend consulting a physician at your appointment rather than making a self-diagnosis.

How the Alar Base Affects Facial Features

The condition of the alar base is closely related to the appearance of the nasolabial folds, the mouth area, and the mid-face impression.

Here we explain, from three perspectives, how recession of the alar base can affect facial features.

Relationship with the Appearance of Prominent Nasolabial Folds

The alar base is the starting point where nasolabial folds begin.

Therefore, if this area is recessed and sunken, the nasolabial folds may appear deeper even when skin sagging is not significant.

However, the appearance of nasolabial folds is influenced by multiple factors, including skin sagging and the amount of fat. A physician's examination is required to accurately identify the cause.

Relationship with the Appearance of a Protruding Mouth and an Aged Look

When the alar base is recessed, the mouth area may relatively appear to protrude forward.

As a result, this can lead to an impression similar to lip protrusion, or make the entire face look flat and aged.

The sense of protrusion around the mouth is often influenced by a combination of factors such as bone structure, dental alignment, and the condition of the alar base, so if you are concerned, we recommend consulting a physician about the related areas together.

Relationship with the Appearance of the Nostrils and Mid-Face

A sunken alar base can cast a shadow at the root area, making the center of the face appear recessed, which may contribute to an impression of wider-looking nostrils and a lack of three-dimensionality in the mid-face.

However, nostril width can also be caused by the shape of the alar wings themselves, and the appropriate approach differs depending on the cause. Please avoid self-diagnosis and have your condition assessed during a medical consultation.

Main Causes of Alar Base Recession

Alar base recession can be broadly divided into two categories: congenital factors related to bone structure, and changes due to aging.

Here we explain how each factor relates to the condition of the alar base.

Congenital Factors Related to Bone Structure

Alar base recession may be related to an individual's innate bone structure.

In many cases, this is attributed to modest development of the maxilla, which forms the foundation of the nose; when the projection of the maxilla is limited, the alar base situated above it also tends to recede.

Such skeletal characteristics can be associated with a tendency for the center of the face to appear flat, and are said to be relatively common among Asians.

When the cause is congenital, changes through self-care are often difficult to achieve.

Changes Due to Aging

Aging is also one of the factors that can make a sunken alar base more noticeable.

As we age, changes such as bone thinning at the foundation and the descent of cheek fat and skin can occur. These changes may make the sunken appearance of the alar base more pronounced compared to younger years.

Age-related changes often appear in combination with nasolabial folds and sagging around the mouth.

Therefore, it is necessary to determine through a medical examination whether the sunken appearance is caused by the alar base or by sagging.

KAI CLINIC TOKYO's Surgical Approach to the Alar Base

Approaches for improving the alar base include hyaluronic acid injection and alar base augmentation surgery (noble lift surgery).

Since each differs in its characteristics, downtime, and risks, we will introduce the details of both treatments in turn below.

Please note that all of the following are cosmetic (self-pay) treatments, and a medical consultation is required to determine suitability.

Hyaluronic Acid Injection

Hyaluronic acid injection is a treatment that injects hyaluronic acid into depressed areas to add volume and make shadows less noticeable.

Since hyaluronic acid is a substance naturally present in the human body, it blends well with the skin and is characterized by relatively minimal downtime.

Additionally, because no scalpel is used, this treatment is often considered by those who are hesitant about incisions.

Hyaluronic acid injection is suitable for those concerned about depression at the alar base, the area where nasolabial folds begin to form, a protruding appearance around the mouth, or a flat facial impression; however, since it is gradually absorbed by the body over time, the duration of its effects is limited.

• Downtime: Swelling and redness may occur but generally subside within 2–3 days
• Side effects/risks: Swelling, bruising, rare cases of vascular occlusion (intra-vascular injection), infection, allergic reactions

Learn more about hyaluronic acid injection

Alar Base Augmentation (Noble Surgery)

Alar base augmentation (noble surgery) is a treatment that projects the base of the nose forward to correct a sunken appearance.

It uses a prosthesis or cartilage to physically lift the base of the nose, with effects that tend to last for a long period and scars that are barely noticeable. When performed in combination with other nose surgeries, more pronounced results can be achieved.

Furthermore, while hyaluronic acid injection has a limited duration of effect, this procedure addresses the foundation itself, making it suitable for those seeking a more fundamental improvement.

• Downtime: Swelling and bruising may occur after surgery
• Side effects/risks: Swelling, redness, bruising, pain, tightness, irregularities (improving over time)

[Pricing] ¥275,000

Learn more about noble surgery (alar base augmentation)

Key Points When Choosing Alar Base Treatment

When it comes to alar base treatment, accurately identifying the cause and confirming details during consultation are important steps to avoid regret.

Here we explain two key points to keep in mind when considering treatment options.

Why Identifying the Cause Matters

The appearance of depression at the alar base and nasolabial folds can be influenced by multiple factors, including bone structure, aging, fat, and sagging.

The direction of treatment considered will differ depending on whether the cause is skeletal or age-related sagging, so the appropriate treatment varies according to the underlying cause.

Since these factors are difficult to assess on your own, having your condition evaluated during a medical consultation is the first step toward making a decision you won't regret.

What to Confirm During Consultation

During consultation, be sure to confirm in advance: suitability for your concerns, risks and side effects, downtime, costs, expected results, and revision policies.

Organize any questions you have beforehand and do not hesitate to ask anything you are unsure about.

The thoroughness of the explanation and the level of satisfaction with the response are factors to consider when choosing a clinic.

KAI CLINIC TOKYO Cases Related to Alar Base Treatment

Here we introduce cases performed at KAI CLINIC TOKYO that included an approach to the alar base.

Mid-face Contouring (Full Nose + Noble Surgery)

【Surgeon】
Mitsunori Harima
【Treatment Details】
Full nose (nasal tip plasty: ¥330,000, septal extension: ¥495,000, augmentation rhinoplasty: ¥330,000, costal cartilage harvest: ¥660,000, auricular cartilage harvest (unilateral): ¥165,000), alar base augmentation (noble surgery): ¥275,000
【Risks/Side Effects】
Swelling, asymmetry, bruising, infection, scarring, hyperpigmentation, pain, numbness, sensory abnormalities, bone displacement, intraoral tightness, facial nerve palsy, sagging, allergic reactions, etc.

Learn more about mid-face contouring (Full Nose + Alarplasty)

Full Nose

【Surgeon】
Takafumi Saito
【Procedure Details】
Costal cartilage harvesting: ¥660,000, Auricular cartilage harvesting: ¥165,000, Septum extension: ¥495,000, Tip plasty: ¥330,000, Alar base reduction: ¥275,000, General anesthesia: ¥220,000, FatXcore (1 vial | under chin): ¥165,000
【Risks & Side Effects】
Swelling, bruising, pain, edema, redness, scarring, infection, etc.

Learn more about Full Nose cases

For concerns about the alar base, please consult KAI CLINIC TOKYO

The appearance of hollowness at the alar base and nasolabial folds can be influenced by multiple factors such as bone structure, aging, and sagging, and the appropriate treatment differs depending on the cause.

Since it can be difficult to identify the cause on your own, consulting a specialist first to properly understand your condition will lead to a decision you can feel confident about.

At KAI CLINIC TOKYO, after assessing each patient's bone structure and concerns, we propose methods suited to their condition and wishes, ranging from hyaluronic acid injections to alar base surgery (alarplasty).

We will carefully explain the risks, downtime, and costs in advance, and work together with you to determine a treatment plan you are comfortable with, so if you have any concerns about the alar base, please feel free to consult our clinic.

Summary

The alar base is located at the root of the nostrils and serves as one of the foundations supporting the three-dimensionality of the central face and the impression of the mouth area.

When this area recedes, it can make nasolabial folds appear deeper or the mouth area look more prominent, resulting in an aged appearance.

The causes include congenital factors related to bone structure as well as age-related changes, and the appropriate improvement method differs depending on the cause.

At KAI CLINIC TOKYO, we provide diagnosis and proposals tailored to each individual's condition.

"I want to do something about the hollowness beside my nose and my nasolabial folds."

If you have such concerns, please feel free to consult our clinic.

We will do our very best to help each patient achieve the beauty they are striving for.