To introduce a case of local skin necrosis by hematoma after alar reduction. A 20-year-old female patient underwent comprehensive rhinoplasty with ear cartilage paddind nose tipand and alar reduction. After 7 days, the right nasal alar wound was covered with blood scabs, and poorly healed. Debridement and suturing were performed. On the 7th day after debridement, there was sudden blackening of the incision edge which enlarged the area. The patient was treated with dressing change for 18 days but did not improve. She came to the First Affiliated Hospital of Guangxi University of Chinese Medicine for treatment. The hematoma was cleared and the bleeding points were explored. After multiple routine dressing changes, the skin on the wound edge became necrotic, turning black and dry before removal. After 25 days of dressing changes, no skin flap repair was performed, and the wound healed without obvious scars. The nose was basically on the opposite side. Therefore, attention should also be paid to preventing hematoma during alar reduction. For small amounts of hematoma in special areas, timely treatment should be taken to avoid skin necrosis and ulceration.

To introduce a case of local skin necrosis by hematoma after alar reduction. A 20-year-old female patient underwent comprehensive rhinoplasty with ear cartilage paddind nose tipand and alar reduction. After 7 days, the right nasal alar wound was covered with blood scabs, and poorly healed. Debridement and suturing were performed. On the 7th day after debridement, there was sudden blackening of the incision edge which enlarged the area. The patient was treated with dressing change for 18 days but did not improve. She came to the First Affiliated Hospital of Guangxi University of Chinese Medicine for treatment. The hematoma was cleared and the bleeding points were explored. After multiple routine dressing changes, the skin on the wound edge became necrotic, turning black and dry before removal. After 25 days of dressing changes, no skin flap repair was performed, and the wound healed without obvious scars. The nose was basically on the opposite side. Therefore, attention should also be paid to preventing hematoma during alar reduction. For small amounts of hematoma in special areas, timely treatment should be taken to avoid skin necrosis and ulceration.