Key Takeaways
- The Kizoku procedure (alar base augmentation) places graft material into the hollow at the base of the nostril wings (alar base) to restore three-dimensional definition
- The material is either Gore-Tex (a synthetic implant) or rib cartilage (usually finely diced so it blends in)
- Performed alone it can make the nostril wings look slightly wider, so it is often combined with alar reduction
- Cost: Gore-Tex ¥198,000 / rib cartilage ¥440,000 (tax included; elective treatment)
What Is the Kizoku Procedure (Alar Base Augmentation)?
The Kizoku procedure places Gore-Tex or rib cartilage into the hollow at the base of the nostril wings (the alar base) to build three-dimensional definition. When this area is recessed, the midface (center of the face) looks sunken, creating a flat impression and deep shadows beside the nose (nasolabial folds).
Changes you can expect
- Midface definition: fills the hollow at the base of the nostril wings, giving contour to a flat-looking face
- The inner shadow of deep nasolabial folds: lifts the area nearest the nose from the foundation, making the shadow less noticeable
- Profile impression: brings the base forward, improving the balance of the profile
"Kizoku procedure" (literally "aristocrat surgery") is a popular name; the medical term is alar base augmentation. Its purpose differs from dorsal augmentation, which raises the bridge — the Kizoku procedure refines the three-dimensional definition at the base of the nostril wings.
Who It Suits (Indications)
Whether the Kizoku procedure suits you comes down largely to whether the base of your nostril wings (alar base) is recessed. The following three types are the most likely candidates (suitability is determined by examination, and results vary by individual).
1. A recessed alar base (the most common indication)
- The base of the nostril wings sits set back
- The nasolabial folds start deep right beside the nose
- In profile, a shadow forms at the base of the nostril wings
Because the hollow itself is filled from the foundation, this type tends to notice the change most readily.
2. A midface left behind after septal extension or dorsal augmentation
Raising only the nose can leave it looking "tall, but with hollows right beside it." Adding the Kizoku procedure lets the nose and the midface (center of the face) read as one natural unit.
3. Nasolabial folds that have been deep since youth
For those whose alar base is skeletally low rather than aged, this offers a way to correct the foundation itself instead of repeated filler injections such as hyaluronic acid.
How It Differs from Dorsal Augmentation and the Neko Procedure
Several procedures "add fullness around the nose" and are easily confused, but they are easiest to tell apart by the area each one refines.
| Procedure | Area refined | Main purpose |
|---|---|---|
| Kizoku procedure (alar base augmentation) | Base of the nostril wings | Fill the hollow at the base to build definition |
| Dorsal augmentation | Bridge (dorsum) | Raise the bridge of the nose |
| Neko procedure | Under the nose (base of the columella) | Graft cartilage into the hollow to bring it forward |
Because their goals differ, they can be combined to refine the bridge, the tip, and the base each in turn. For the full picture, see the complete guide to rhinoplasty techniques.
Choosing Between Gore-Tex and Rib Cartilage
The graft material is either Gore-Tex or rib cartilage. It is not a matter of better or worse — the choice depends on the definition you want, how you feel about implants, and where the scar sits.
| Item | Gore-Tex | Rib cartilage |
|---|---|---|
| Type | Medical-grade synthetic material (Gore-Tex) | Your own costal cartilage (usually finely diced before placement) |
| Shaping the result | Easy to shape; handy for fine-tuning asymmetry | Dicing it finely helps it blend in naturally and makes volume easy to adjust |
| Additional scar | No donor-site scar | A few centimeters on the chest |
| Best suited for | Avoiding a donor-site scar; correcting asymmetry | Avoiding implants; a natural, fully autologous finish |
| Main cautions | As an implant: infection, displacement, removal if needed | Donor-site burden (chest scar, pain, etc.) |
How we use rib cartilage
- Rib cartilage is sometimes placed as a solid block, but in most cases we dice it finely before placement
- Dicing helps it integrate with the surrounding tissue, making it easier to achieve natural-looking volume
Our Kizoku Procedure
A distinctive point of our clinic is that we usually insert the material from deep inside the nostril (the nasal-cavity side). The reasoning: we want to avoid, as far as possible, the infections that an approach through the mouth can invite. No visible scars are left on the surface of the face.
When alar reduction (a procedure to make the nostril wings smaller) is performed at the same time, we may approach through its incision instead.
Also, because the Kizoku procedure performed alone can make the nostril wings look slightly wider, we often combine it with alar reduction. If you also want to refine the tip, the bridge, or other areas, we combine it with rhinoplasty and design the overall balance together.
How we think about design
Case Photos (Front, Oblique, Side)
Cases are shown from three angles — front, oblique, and side — because with the Kizoku procedure the balance between profile and front views matters most. Use the tabs to switch angles.
Case | Nasal roundness and weak tip support (comprehensive rhinoplasty including the Kizoku procedure) / Closed technique
- Procedure
- Closed technique: osteotomy (bone narrowing) + tip plasty + cartilage grafting + columellar strut + Kizoku procedure + Neko procedure + alar reduction
- Price
- ¥980,000〜 (combination of multiple techniques)
- Main risks / side effects
- Swelling, bruising, asymmetry, infection, implant displacement, individual variation in results, etc.
- Downtime
- About 1–2 weeks (photos taken 1 month after surgery)
* A case combining multiple techniques including the Kizoku procedure, shown from three angles: front, oblique, and side. Patient in her 30s (published with consent; eye area edited for privacy). Results vary by individual and involve risks and side effects. Elective treatment (not covered by insurance).
Cost
The cost of the Kizoku procedure depends on the material used (tax included). When combined with alar reduction or other techniques, the total is determined by the treatment plan.
| Kizoku procedure (Gore-Tex) | ¥198,000 |
|---|---|
| Kizoku procedure (rib cartilage) | ¥440,000 |
Pricing details (additional fees / monitor program)
Downtime
Swelling and bruising usually settle within about 1–2 weeks. If the approach was through the mouth, you may feel swelling and tightness around the upper lip and some difficulty eating for a while.
If rib cartilage is harvested, chest-wound pain may last several days to about a week. Recovery varies by individual, so we recommend scheduling surgery at least 1–2 months before any major event. For procedure-by-procedure recovery timelines, see the complete downtime guide.
Risks and Side Effects
The Kizoku procedure can involve the following risks and side effects. Please be sure to review them.
Main risks and side effects
- Swelling, bruising, pain, puffiness (these usually ease with time)
- Asymmetry; changes in fullness and how the mouth area looks, depending on the amount placed
- Performed alone, the nostril wings may look slightly wider (often addressed by combining alar reduction)
- If alar reduction is combined, scars form at the outer edge of the nostril wings or similar sites
- With Gore-Tex (an implant): infection, displacement, exposure, removal if needed
- If rib cartilage is harvested: chest scar and pain, donor-site deformity, and rarely pneumothorax
- Infection, results that differ from the imagined outcome, individual variation in results
Revision of Surgery Performed Elsewhere
We also handle replacement or removal of Kizoku-procedure implants placed at other clinics, and rebuilding combined with removal of mesh or Osteopore implants.
"The implant from a Kizoku procedure at another clinic bothers me" or "It was overfilled and looks unnatural" — we take on these consultations as well. Because the revision plan varies greatly with the condition, please let us first examine your current state. For the full picture of the techniques we can offer, see the revision section of the technique guide.
Frequently Asked Questions
Does the Kizoku procedure leave scars on my face?
At our clinic we usually insert the material from deep inside the nostril (the nasal-cavity side), so no visible scars are left on the surface of the face. If alar reduction is performed at the same time, we use its incision (at the outer edge of the nostril wings or similar). The approach is decided based on your condition and explained at counseling.
Will the Kizoku procedure widen my nostril wings?
Performed alone, the Kizoku procedure can make the nostril wings look slightly wider. For that reason we often combine it with alar reduction, controlling the width while building definition at the base.
Gore-Tex or rib cartilage — which is better?
If you want to avoid a donor-site scar or correct asymmetry, Gore-Tex suits; if you want to avoid implants and prefer a natural, fully autologous finish, rib cartilage suits. At our clinic we usually dice the rib cartilage finely so it blends into the surrounding tissue. We decide at your examination based on your wishes and condition.
Will it erase my nasolabial folds?
By lifting the recessed area nearest the nose from the foundation, the shadow can become less noticeable in some cases. Nasolabial folds have multiple causes, so whether the Kizoku procedure is appropriate is determined by examination. Results vary by individual.
How is it different from dorsal augmentation?
Dorsal augmentation raises the bridge of the nose, while the Kizoku procedure builds definition at the base of the nostril wings — they target different areas. The two can also be combined.
Can you revise a Kizoku procedure done at another clinic?
Yes — we handle implant replacement and removal, as well as rebuilding combined with removal of mesh or Osteopore implants. Because the plan depends on the condition, we decide after an examination.
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Considering the Kizoku Procedure in Fukuoka?
The definition at the base of the nostril wings depends on the amount placed, the material chosen, and the balance between profile and front views. A surgeon with more than 2,000 rhinoplasty procedures will examine you and propose exactly what you need.
* This article is intended to provide general medical information and does not guarantee results. The suitability, cost, and risks of treatment are determined individually through examination. Results vary from person to person. Rhinoplasty and the Kizoku procedure are elective treatments (not covered by insurance).