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Transcutaneous Alar Rim Graft : An Effective Technique to Manage Alar Deformity

Rhinoplasty is one of the most challenging cosmetic surgical procedures. Although different techniques have been introduced for grafting the osteocartilaginous part of the nose, the alar rim remains vastly unexamined. The form and strength of the alar rim are crucial in nasal tip esthetics and function. External valve collapse may occur owing to trauma, congenital weakness, or malposition of the lower lateral cartilage (LLC). Alar pinching and collapse are possible outcomes if there is any over-resection of the cephalic portion of the LLC. Traditionally, the closed technique creates a tunnel, dissected along an incision made in the soft triangle lining near the most anterior portion of the nostril rim. Alar rim grafts also can run through the marginal incision. The main goal of this study was to introduce a straightforward and effective technique for alar rim grafting, which can help surgeons with more precise placement. A total of 84 patients (61 female and 13 male patients) underwent transcutaneous alar rim grafting. After the alar base resection, a 2-mm stab incision was made in the bulk of the incised alar, using a No. 11 blade. Thereafter, a pocket was created through the alar fibrofatty tissue, which crossed the ala up to near the dome, and a cartilage graft was inserted in the tunnel. Transcutaneous alar rim grafting is a simple and effective approach to provide support for the external nasal valve and increase alar harmony. If the nasal tip analysis shows malpositioned LLC, alar flaring, an over-projected nasal tip, mild retraction, or contour asymmetries, this type of grafting may prove effective in primary or secondary rhinoplasty

Year of Publication: 2020
Contained in: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons Vol. 78, No. 5 (2020), p. 821.e1-821.e8
All journal articles: Search for all articles in this journal
Language: English
Contributors: Fallahi, Hamid Reza | Author
Keyhan, Seied Omid
Fattahi, Tirbod
Zandian, Dana
Full text access:
Electronic availability is being checked...
Links: Full Text (dx.doi.org)
Keywords: Journal Article
ISSN: 1531-5053
Note: Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Notes: Date Revised 04.05.2020
published: Print-Electronic
Citation Status In-Data-Review
Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
PMID:
    31899163
Physical Description: Online-Ressource
ID (e.g. DOI, URN): 10.1016/j.joms.2019.12.002
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