Modification of the Basal View after Internal Alar Reduction | ||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||
| Article 9, Volume 44, Issue 3, July 2020, Pages 453-462 PDF (22.6 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejprs.2020.122308 | ||
| Authors | ||
| Laila Abol Nasr* ; Sarah S Raafat; Motaz Narsha; Sherif Z Ezzat; Youssef Khachaba | ||
| The Department of Plastic Surgery, Faculty of Medicine, Cairo University, Egypt | ||
| Abstract | ||
| Background: Numerous alar base modification techniques have been reported in the literature. Specifically, three different techniques were described to manage cases with alar flaring in addition to a wide nasal base. Tissue excision from the alar lobule as well as from the inside of the nostril is executed to decrease the alar flaring and the nostril width, respectively. Further techniques include cinching sutures that help advance the alae together and flap advancement. The aim of this study is to emphasize the aesthetic impact of the basal nasal view and to reach a maximum aesthetic result concerning nasal alar flare. Patients and Methods: A prospective study was conducted on 25 patients. All patients had alar flaring seeking alar reduction, either alone or as a part of a full rhinoplasty. During rhinoplasty, alar base reduction was done at the end of rhinoplasty surgery, after the closure of all rhinoplasty incisions and after osteotomy was done. A caliper was used to sharply stab the skin from the lateral limb to the desired sill crease to determine the medial limb of the triangular wedge to be excised. The base of the triangular wedge was directed downward and the apex was directed intra-nasally. Results: The current study showed that the internal alar resection significantly decrease the alar flare; as the inter-alar distance ranged between (35-43mm), Mean±SD (39.2±2.3) before surgery and becomes between (31-37mm) Mean±SD (34.8±2.0) after the surgery, with a significant improvement (p-value: <0.001). Conclusion: Internal alar resection effectively reduced the alar flare, and improved the nostril shape and width. This technique was also useful to retain symmetry of nostril shape, hide the scars internally in the nose, avoid the injury of the lateral nasal artery, preserve the natural curvature of alar rim and avoid detachment of the alar foot plate. This technique can effectually be applied to all patients with alar flare reduction | ||
| Keywords | ||
| Rhinoplasty; Alar reduction; Internal; Basal view | ||
| References | ||
|
1- Dickie, Sara R., Peter A., Adamson and Jeremy P. Warner: "Alar Base Reduction". Advanced Aesthetic Rhinoplasty. Springer, Berlin, Heidelberg, 425-434, 2013. 2- Adamson, Peter A., et al.: "Revision rhinoplasty: Panel discussion, controversies, and techniques". Facial Plastic Surgery Clinics, 22.1: 57-96, 2014. 3- Numa W. and C.M. Johnson Jr.: "Surgical anatomy and physiology of the nose". Master Techniques in Rhinoplasty. 2011 1st ed Saunders Elsevier, 21-30, 2011. 4- Hudise, Jibril Y., et al.: "Evaluation of Scar Outcome After Alar Base Reduction Using Different Surgical Approaches". Journal of Oral and Maxillofacial Surgery, 2020. 5- Foda, Hossam M.T.: "Nasal base narrowing: The combined alar base excision technique". Archives of Facial Plastic Surgery, 9.1: 30-34, 2007. 6- Lima, Leila Freire Rego, Helena Hotz Arroyo and José Roberto Parisi Jurado: "Update in alar base reduction in rhinoplasty". Current Opinion in Otolaryngology & Head and Neck Surgery, 24.4: 316-321, 2016. 7- Hamilton III and Grant S.: "YV alar base reduction". Ear, Nose & Throat Journal, 93.3: 98-102, 2014. 8- Peng, Grace Lee and Paul S. Nassif: "Rhinoplasty in the African American patient: Anatomic considerations and technical pearls." Clinics in Plastic Surgery, 43.1: 255- 264, 2016. 9- Harrar, Harpal, Simon Myers and Ali M. Ghanem: "Art or science? An evidence-based approach to human facial beauty a quantitative analysis towards an informed clinical aesthetic practice". Aesthetic Plastic Surgery, 42.1: 137- 146, 2018. 10- Rohrich, Rod J., et al.: "Managing alar flare in rhinoplasty". Plastic and Reconstructive Surgery, 140.5: 910-919, 2017. 11- Casanueva, Fernando and Deniz Gerecci: "Objective comparison of nasal tip contours in the basal view between dome binding and hemitransdomal tip suture techniques in rhinoplasty". JAMA Facial Plastic Surgery, 18.6: 481- 487, 2016. 12- Ismail, Ahmed Soliman: "Nasal base narrowing: the alar flap advancement technique". Otolaryngology Head and Neck Surgery, 144.1: 48-52, 2011. 13- Kim, Ji Heui, Joon Pyo Park and Yong Ju Jang: "Aesthetic outcomes of alar base resection in Asian patients undergoing rhinoplasty". JAMA Facial Plastic Surgery, 18.6: 462-466, 2016. 14- Foda H.M.: "Nasal base reduction". J. Asthet. Chir., 7: 8- 15, 2014. 15- Kumar S., M. Aslam and M. Yaseen: "Alar base resectionmedial flap technique". Indian Journal of Otolaryngology and Head and Neck Surgery, 58.4: 347-348, 2006. 16- Stucker, Fred J., Timothy Lian and Kenneth Sanders: "African American rhinoplasty". Facial Plastic Surgery Clinics, 13.1: 65-72, 2005. 17- Bafaqeeh, Sameer A. and Mohammad M. Al-Qattan: "Simultaneous open rhinoplasty and alar base excision: Is there a problem with the blood supply of the nasal tip and columellar skin?". Plastic and Reconstructive Surgery, 105.1: 344-349, 2000. 18- Scuderi, Nicolò and Bryant A. Toth, eds.: International Textbook of Aesthetic Surgery. Springer, 2016. 462 Vol. 44, No. 3 / Modification of the Basal View after Internal Alar Reduction 19- Kridel, Russell W.H. and Richard D. Castellano: "A simplified approach to alar base reduction: A review of 124 patients over 20 years". Archives of Facial Plastic Surgery, 7.2: 81-93, 2005. 20- Uzun, Ahmet and Fikri Ozdemir: "Morphometric analysis of nasal shapes and angles in young adults". Brazilian Journal of Otorhinolaryngology, 80.5: 397-402, 2014 | ||
|
Statistics Article View: 281 PDF Download: 1,481 |
||
