When you are having rhinoplasty don’t be concerned about how long [within reason] the case takes or the cost of the operating room fee. Would you prefer that the surgeon does it quickly, but with perhaps less attention to detail and perhaps leaving out an important step? There is usually nothing good about a fast rhinoplasty. We do an Alar base reduction typically to narrow widely flared nostrils but occasionally also to decrease a disproportionately elongated nostril and more rarely to thin a Rhinophyma type thick skinned nostril…and each procedure requires careful planning and exact realignment of the light reflex from the reduced nostril to merge with that of the nostril floor or sill. There needs to be a medial flap to offset the scar and make it less notched and noticeable. The surrounding cheek must be undermined for about 8-10 mm and pulled in toward the mid-line by a cinching dissolvable suture which secures the cheek to the deep fascia near the anterior nasal spine with is deep at the bone at the base of the columella. Without such a “cinching” suture there will be a “Tug of War” between the cheek and the poor fragile nostril and the cheek will win and prevent proper narrowing. Also there is the nuance of splitting the outer dermis with a fine blade to prevent ruffling of the skin closure should it appear. In addition, be sure you want it done (nostrils should not be made more narrow than the distance between your eyes) since there is a scar that is typically hidden in the Alar crease but could be more obvious if hurried. So it is a wonderful operation and adjunct to rhinoplasty but should not be looked at as a quick and simple procedure…by the patient or by the surgeon. Have it done right the first time and find an ASPS plastic surgeon or an Ear, Nose and Throat trained facial plastic surgeon. Good luck!