Joseph Nasal Knife — Curved for Alar Base Reduction

Joseph Nasal Knife — Curved Alar-Base Variant

The curved Joseph variant is the knife for alar-base reduction — the Weir excision and its modifications, in which a wedge of alar tissue is removed at the nostril base to narrow a wide or flaring nostril. The curved blade follows the natural arc of the alar margin, producing the wedge geometry that closes without distortion of the nostril aperture.

The Weir excision technique

The alar-base reduction is performed at the end of the rhinoplasty when the dorsal and tip work has been completed and the final nostril proportion can be judged in the upright position. The curved Joseph knife defines the wedge through a hidden incision in the alar-facial junction; suture closure with 6-0 fast-absorbing gut leaves a hairline scar invisible at conversational distance.

Why curve rather than straight

A straight cut at the alar base produces an inverted-V notch that is visible on three-quarter view; the curved Joseph follows the natural alar curvature, and the closure heals along the natural anatomic line. The detail is one of the marks of a senior rhinoplasty surgeon.