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Plastic Surgery/alar cinch suture


QUESTION: How effective is an alar cinch suture in reducing nasal base widening and flaring. I had a premaxillary implant put in for less than a month and then removed. It changed my nose it has widened the base by approximately 3mm-4mm, this was over 12 months ago. How many millimetres can the suture reduce the width by, and how does it effect the upper lip, does it look fuller? does the middle area between mouth and nose appear fuller too (subnasal area) ? How does it effect the nasolabial angle.

ANSWER: As the alar flare is about 4 mm in your estimate and if it is 4 mm on each side [a total of 8mm], then you might also need a small excision of skin and tissue at the nasal sill in addition ot an alar cinch. If the flare is say 4 mm total, a cinch alone might be enough. It does give you a bit of fullness on the lower lip  including the subnasal area. Do not expect it to open up the nasolabial angle though.

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QUESTION: Thank you that is very helpfull. I don't really understand the nasolabial angle aspect I read an article saying it increases it but I don't know what that means or how to picture it? Does the angle go in more at the base of the nose and protrude out towards the lip? Yes it's 1.5-2 mm wider per side so 3-4mm total.

the subnasal angle is the angle between the profile line of the lip [the white part and not the red part] and the profile line of the nose columella. in the side photograph if you trace a line from the root of nose to the tip and then come down on the columella, then you turn at the subnasal angle to continue the trace on the lip. So that is the subnasal. in a cinch that angle might go a bit obtuse i.e the tip of nose is tilted upwards a bit that is all. This effect is minimal.

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Mohan Rangaswamy


I am a certified plastic surgeon with special interest on aesthetic surgery, practising in Dubai, U.A.E. dealing with patients form diverse nationalities. You can address questions to me on body and facial aesthetic surgery (liposuction, breast surgery, nose corrections, eyelid surgery, fat injections, botox and fillers) as well as reconstructive surgery. I also have experise in the area of peripheral nerve surgery such as carpal tunnel syndrome and other nerve entrapments. I would especially welcome queries from net-surfers from this part of the world.


I have 17 years experience in reconstructive plastic surgery and over 12 years in aesthetic surgery. After qualifying as a general surgeon, I was fortunate to work in a unit that did complex reconstructive surgery and general surgery as well. This spurred my interest in plastic surgery as a career as the possibilities seemed to be amazing and limitless. This was the era when microsurgery and flaps captured our imagination. I further acquired formal training in Plastic surgery, burns, maxillofacial and hand surgery. this was followed by a training apprenticeship in aesthetic surgery. In my practice as a plastic surgeon, I do more aesthetic work now and am keen on developing minimal invasive surgery. I am a member of the Association of Plastic Surgeons of India, International Society of Aesthetic Plastic Surgeons, Royal college of Physicians and Surgeons, Glasgow, U.K.

Professional: Plastic and Reconstructive surgery journal, Acta Tropica, European journal of OB & Gyn etc.

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