title: Alar expansion and reinforcement: a new technique to manage nasal valve collapse.
abstract: OBJECTIVE
  To describe the new technique of alar expansion and reinforcement as a comprehensive approach to the surgical management of nasal valve collapse.
  
  
  METHODS
  Alar expansion and reinforcement expands the narrow nasal valve and reinforces the floppy nasal sidewall. Forty-one patients underwent rhinoplastic surgery for nasal valve collapse between May 1, 2002, and April 30, 2005, using an external rhinoplasty approach; of these, 32 responded to our postoperative questionnaire. Twenty-four patients (75%) underwent primary surgery and 8 (25%) had undergone previous rhinoplasty. All patients had permanent adjustable expansion sutures. Twelve patients (38%) had an excessively floppy nasal sidewall that required a high-density porous polyethylene alar batten implant to anchor the expansion sutures. Patients underwent clinical review from 6 months to 3 years after surgery, and a telephone survey was used to evaluate their functional and cosmetic satisfaction rates.
  
  
  RESULTS
  Thirty patients (94%) experienced good improvement in their nasal airway. The improvement in nasal airway patency was statistically significant (P<.001). Two patients (6%) reported no improvement. There were no complications. Cosmetic outcome was satisfactory in all 8 patients who also requested cosmetic improvement. Of the 24 patients who had surgery for nasal obstruction only, 10 (42%) rated their cosmetic appearance as better, with the remaining 14 (58%) indicating that they did not identify any significant change in their nasal appearance.
  
  
  CONCLUSIONS
  Alar expansion and reinforcement is a safe, reliable, and effective technique to manage nasal valve collapse.
authors.affiliation: Stuart Clinic, Sydney, Australia. mm@face.au.com
authors.forename: Martyn S
authors.initials: MS
authors.lastname: Mendelsohn
authors.forename: Kambiz
authors.initials: K
authors.lastname: Golchin
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000601:surgery*; D015508:Nasal Obstruction / Q000601:surgery*; D009300:Nasal Septum / Q000601:surgery*; D017060:Patient Satisfaction; D020959:Polyethylene; D012225:Rhinoplasty / Q000379:methods*; D013536:Suture Techniques; D015626:Tissue Expansion / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D020959:Polyethylene