Alar rim grafting in rhinoplasty: indications, technique, and outcomes.
OBJECTIVE
To determine the potential indications for placement of cartilaginous alar rim grafts in primary and revision septorhinoplasty.


METHODS
Retrospective medical chart analysis of all patients undergoing septorhinoplasty from March 2003 through June 2004 in a private facial plastic and reconstructive surgery center and a tertiary teaching hospital. Patients who received alar rim grafts were identified. The indications for placement of the alar rim grafts were deduced from their preoperative evaluation and intraoperative assessment as noted in their comprehensive operative notes. Preoperative and postoperative digital photographs as well as postoperative medical records were analyzed for alar contour, pertinent patient complaints, and complications.


RESULTS
During the 15-month study period, 150 patients underwent septorhinoplasty performed by the senior author. Of these patients, 31 received alar rim grafts. The most frequent indications for placement of alar rim grafts were cephalic malposition of the lower lateral cartilage with inadequate alar support (9 patients [29%]), correction of alar flare (9 patients [29%]), and correction of dynamic alar margin collapse (8 patients [26%]). At a mean 6-month follow-up, there were no graft displacements or extrusion.


CONCLUSIONS
Alar rim grafting is a simple and versatile approach to providing additional support to the external nasal valve and for improving nasal base contour.
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N Caroline St, Sixth Floor, Baltimore, MD 21878, USA. dboahen1@jhmi.edu
Kofi D O
KD
Boahene
Peter A
PA
Hilger
D000293:Adolescent; D000328:Adult; D002356:Cartilage / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D016896:Treatment Outcome