In this followup video to a previous version several years ago, Dr. Zelken tackles a revision nasal alar reduction in a handsome young black man. The previous surgery (done elsewhere) appears to have been performed well, but perhaps too conservatively. In this revision, it is important to affect change, and the stakes are higher. To ensure that history doesn’t repeat itself, Dr. Zelken adds an alar cinch suture, a permanent stitch, to bring the footprint of the new nostrils closer together. Then, and only then, can he safely sew the nostrils to the cheeks. Also, in contrast to a previous video, Dr. Zelken does place two deep stitches on each side because 9mm of nostril was removed and sutures will need to be removed at 5 days.
It’s all about the footprint. Keep it small. And a permanent stitch to prevent recurrence.
This procedure is well established, but Dr. Zelken’s refinements confer superlative results. Nostril flaring reduction is popular amongst all races, but perhaps more amongst Black and Asian patients. Historically, rhinoplasty was a means of Westernizing noses of various ethnic and religious groups to a European and Caucasian standard. Dr. Zelken spent a year in Asia and has trained under experts who are famed for their innovations. He has written several papers on the topic of Asian rhinoplasty. As worldwide wealth accumulates amongst ethnic Asians and stigma dissipates, there is an increasing demand for aesthetic surgery that emphasizes enhancement of natural beauty rather than Westernization. Asian rhinoplasty is increasingly common, second to blepharoplasty in popularity.