Abstract
OBJECTIVE
1) Demonstrates the efficacy of the alar sliding graft in getting better alar contour results in cases of alar base narrowing. 2) Illustrates the different surgical techniques for alar base reduction and the success rates of each technique.
METHOD
This is a retrospective study of the alar sliding graft technique in cases of alar base narrowing. This technique was applied on 59 patients needing alar base reduction, either separately or in combination with different rhinoplasty techniques. The alar sliding graft is harvested from the nasal septal cartilage during septoplasty (36 cases, 61%) or from a separate incision in patients who are only undergoing alar base reduction (12 cases, 20.3%), or rhinoplasty surgery alone (11 cases, 11.7%). Introduction of the alar sliding graft is performed through a lateral incision at the nasofacial groove after creating a tunnel through the alar margin to a point just lateral to the lateral edge of nasal dome. Evaluation of the surgical outcome was performed 1, 6, and 12 months post-operatively using doctor and patient assessment scores, together with measuring the degree of alar flare.
RESULTS
Patient satisfaction was excellent to good in 54 patients (91.5%). Two patients (3.4%) recorded fair results, while 3 patients (5.1%) recorded poor results. Doctor satisfaction was 56 (94.9%) as excellent to good, one patient (1.7%) as fair, and two patients (3.4%) as poor results.
CONCLUSION
The alar sliding graft had been used for many years for correcting alar collapse and expanding the nasal tip, in hard cases of retracted alar margin, in revision rhinoplasty. To my knowledge, this is the first study to discuss the use of the alar sliding graft in patients undergoing alar base reduction for better alar contour. The patient and doctor satisfaction is encouraging. Compared to previous results from the literature, this technique gives better cosmetic results and is easy to apply and learn.