scholarly journals Correction of alar rim retraction by lateral crural extension graft

2020 ◽  
Vol 40 (3) ◽  
pp. 211-216
Author(s):  
Tito Matteo Marianetti ◽  
Antonio Moretti
Keyword(s):  
Extension Graft ◽  
Alar Rim

Lateral Crural Tensioning for Refinement of the Nasal Tip and Increasing Alar Stability: A Case Series

2017 ◽  
Vol 33 (03) ◽  
pp. 316-323 ◽  
Author(s):  
Allen Foulad ◽  
Veronika Volgger ◽  
Brian Wong
Keyword(s):  
Nasal Obstruction ◽  
Case Series ◽  
Cosmetic Outcome ◽  
Medical Review ◽  
Nasal Valve ◽  
Nasal Tip ◽  
Technical Details ◽  
External Nasal Valve ◽  
Extension Graft ◽  
Alar Rim

AbstractThe objective of this study was to discuss the technical details and our experiences with lateral crural tensioning (LCT) in both functional and aesthetic rhinoplasties. A retrospective medical review was completed for all patients who underwent rhinoplasty with LCT from the years 2011 to 2014. The indications for LCT included correction of lateral crural convexity, boxy tip geometry, and dynamic collapse of the external nasal valve. The details of the rhinoplasty procedure and complications were evaluated. A total of 114 LCT rhinoplasty cases were included in this series. The most common adjunctive maneuvers included placement of spreader grafts (92% of cases) and alar rim grafts (78% of cases). Conventional classic cephalic trim was not performed in any subjects and conservative paradomal cephalic trim was performed in 48% of cases. As experience with the technique progressed, the use of onlay tip grafts decreased and the use of articulated rim grafts increased. Indications for revision were dissatisfaction with cosmetic outcome (4.4% of cases) and nasal obstruction (0.9% of cases). LCT combines traditional lateral crural steal with the use of a caudal septal extension graft to refine the broad tip and increase stability of the alar lobule. This maneuver is essentially cartilage sparing and does not rely on extensive grafting maneuvers that can reduce airway area.

Management of Ala Columella Disproportion in South East Asian Noses

2020 ◽  
Vol 36 (05) ◽  
pp. 505-516
Author(s):  
Eduardo Yap
Keyword(s):  
East Asian ◽  
Frontal View ◽  
Aesthetic Outcome ◽  
Posterior Angle ◽  
Nasal Vestibule ◽  
Aesthetic Result ◽  
Tip Projection ◽  
Good Aesthetic Result ◽  
Extension Graft ◽  
Alar Rim

AbstractSouth East Asian noses have a characteristic ala and columella disproportion and mostly manifest as hanging ala. Simultaneous correction during rhinoplasty is recommended to achieve a good aesthetic result. Since hanging ala is a common feature, a classification system is presented as a guide for surgical management. The classification is based on the frontal view showing the alar rim connecting to the columella lobule area simulating the wings of a gull in gentle flight. A mild deformity has the gull's wing in the horizontal direction. A moderate deformity has the gull's wing in a slight inferior direction. A severe hanging deformity has the gull's wing in the inferior direction, ending below the columella lobule area, and this is mostly accompanied by retracted columella. There are various techniques for the surgical correction of hanging ala. The author has made a modification of the internal approach called “sail excision” using the groove within the lateral nasal vestibule as a landmark. The author terms this area as the vestibular groove. Sail excision involves removal of a triangular portion of tissue anterior to this vestibular groove. Another aesthetic deformity noticed in South East Asian noses is that the alar rim base is lower than the columellar base. In correcting hanging ala with involvement of the alar rim base, the sail excision is extended posteriorly following the vestibular groove as its guide to the amount to be excised. To enhance the overall aesthetic outcome, the acute columella labial angle seen in South East Asian noses has to be made fuller through surgery. This is accomplished using septal extension graft for tip projection, with preservation of the posterior angle of the caudal septum. Plumping grafts are used as filler material in the premaxillary area.

Caudal Extension Graft of the Lower Lateral Cartilage: Technique and Aesthetic and Functional Results

2021 ◽  
Author(s):  
Juliano de Oliveira Sales ◽  
Wolfgang Gubisch ◽  
Rodrigo Ribeiro Ferreira Duarte ◽  
Aline Souza Costa Teixeira Moreno ◽  
Felipe Marques de Oliveira ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Age Groups ◽  
Functional Results ◽  
First Year ◽  
Lateral Cartilage ◽  
Lower Lateral Cartilage ◽  
Alar Retraction ◽  
Outcomes Evaluation ◽  
A New Technique ◽  
Extension Graft

AbstractHere we describe a new technique to deal with alar retraction, a highly undesirable imperfection of the nose. The procedure involves placing a caudal extension graft below the vestibular portion of the lower lateral cartilage (LLC) after its detachment from the vestibular skin. The graft is fixed to the cartilage and, subsequently, to the vestibular tissue. The present retrospective study included 20 patients, 11 females and 9 males, with a mean age of 28.90 years. Follow-up ranged from 1 to 18 months. Surgery improved alar notching to a smoother dome shape and nostril exposure was reduced in every patient. The caudal extension graft of the LLC contributed to rise in overall patient satisfaction, as revealed by the postoperative increase of the Rhinoplasty Outcomes Evaluation (ROE) mean score from 40.0 to 79.17 (p < 0.0001). It also contributed to and improved functional outcomes, as indicated by the decrease of the Nasal Obstruction Symptom Evaluation (NOSE) mean score from 52.75 to 13.25 (p = 0.0001). Sex did not affect the mean ROE and NOSE scores. Thus, increased patient satisfaction measured by the ROE is present in both sexes and at both age groups but it is better detected in the first year after surgery. Functional improvements analyzed with NOSE are best detected in patients aged ≥ 30 years and in follow-ups of 11 months. The caudal extension graft of the LLC technique described herein effectively and safely corrects alar retraction and the collapse of the nasal valve while filling the soft triangle.

Rotation-Transposition Correction of Nasal Deformity in Tessier Number 1 and 2 Clefts

2009 ◽  
Vol 46 (6) ◽  
pp. 674-680 ◽  
Author(s):  
Mamoon Rashid ◽  
Muhammad Zia ul Islam ◽  
Muhammad Sarmad Tamimy ◽  
Ehtesham ul Haq ◽  
Samina Aman ◽  
...  
Keyword(s):  
Lateral Nasal Wall ◽  
Nasal Deformity ◽  
Postoperative Results ◽  
Transposition Flap ◽  
Patients Âgés ◽  
Female Patients ◽  
Minimal Scarring ◽  
Flap Viability ◽  
Alar Rim

Objective: To formulate a standardized procedure for repair of the nasal component of Tessier number 1 and 2 clefts. Patients and Methods: The procedure was performed from 1998 to 2007 in 13 patients with congenital nasal clefts of different degrees of expression corresponding to Tessier 1 and 2. The patients’ ages ranged from 3 months to 28 years. There were 10 male and three female patients. In the absence of any standard published technique for these rare defects, we devised our own method, which we find uniformly applicable to all such cases. We use a composite muco-chondro-cutaneous lateral alar flap to recreate the alar rim. The resulting defect on the lateral nasal wall is then covered with a transposition flap from the dorsum. An alar rim z-plasty was added in cases where notching was evident. Results: In all cases, no problem of flap viability was encountered and all healed well with minimal scarring. The postoperative results were satisfactory and have remained stable over an average 6-month follow-up period. Conclusions: We recommend this technique to be used for the correction of nasal deformity associated with Tessier clefts number 1 and 2. We feel that this technique is relatively simple and easily reproducible.

An Analysis of Lateral Crural Repositioning and Its Effect on Alar Rim Position

2016 ◽  
Vol 18 (2) ◽  
pp. 89
Author(s):  
Christian A. Paquet ◽  
Sim Choroomi ◽  
Andrew S. Frankel
Keyword(s):  
Alar Rim
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