We are going to start making marks for the alar base reduction. Another term is Weir incisions. This mark is along the alar facial crease. We have to make sure that we do this absolutely accurately on both sides.
At this point we are going to remove about 3 mm to 4 mm of tissue and we are going to make some marks so that we know that we have exactly measured it proportionally. This is at 3.5 mm. We will connect the dots.
We are injecting the Weir incisions with some local and that will help control all the bleeding and control all sensation of pain.
We are starting on incisions for the alar base reduction. We start with the inferior incision so that it will not bleed on us. We are being very precise in how we make this incision. We are not entering into the nose with these incisions. We are staying on the outside and only removing the actual skin.
What we are doing is we are comparing the two sides to see how close they are. They are pretty darn close. That is fantastic.
Now we will start the closure. What is extremely important about this procedure is that the closure, putting in the sutures, has to be absolutely perfect. Every stitch has to be placed perfectly and if it is not placed perfectly, remove it and do it again.
We just finished closing the deep layer of the alar base reduction and now we are going to put in a few stitches. These will also come out in a week. I wanted to make sure that every deep stitch I placed was absolutely perfect and I am very happy with that. We will put this little stitch in the skin and we will remove this in one week and hopefully this will heal absolutely perfectly with a very minimal barely noticeable scar.