Objective To observe the application effect of external rhinoplasty in patients with nasal alar retraction. Methods From January 2021 to January 2023, 60 patients with alar recession type were selected from the Department of Aesthetic Surgery of Sichuan BAB Medical Beauty Hospital. They were divided into control group and observation group according to the random number table method, with 30 patients in each group. The control group underwent nostril reduction, and the observation group underwent external rhinoplasty. The external rhinoplasty parameters, nasal aesthetic indexes, clinical efficacy, nasal ventilation function indexes, nasal deformity, nasal ventilation scores and complications were compared between the two groups. Results The nasal length, ideal nasal length, frontal nasal angle and nasolabial angle of the observation group were better than those of the control group, and the differences were statistically significant (P <0.05). The nasal tip protrusion of the observation group was higher than that of the control group, and the nostril exposure was lower than that of the control group (P <0.05). The total effective rate of the observation group was 96.67%, which was higher than 86.67% of the control group, and the difference was statistically significant (P <0.05). The nasal minimum cross-sectional area, nasal volume, nasal expiratory inspiratory resistance and nasal ventilation function indexes of the observation group were better than those of the control group, and the differences were statistically significant (P <0.05). The nasal deformity score and nasal ventilation score of the observation group were lower than those of the control group, and the differences were statistically significant (P <0.05). No complications occurred in both groups. Conclusion The application effect of external rhinoplasty in patients with alar recession type of nostril exposure is better than that of nostril reduction. Meanwhile, external rhinoplasty has a positive effect on improving the nostril exposure of patients with alar recession type, and has more clinical application value.