title: Dynamics of the alar rim graft.
abstract: BACKGROUND
  The purpose of this study was to review the dynamics and frequency of the use of the alar rim graft.
  
  
  METHODS
  The recorded intraoperative information for the purpose of rhinoplasty research was reviewed to investigate the frequency of the use of alar rim grafts. Intraoperative observations were also made while inserting the alar rim graft to identify the changes that occur in the structures that could be influenced by placement of this graft. The data were tabulated in an Excel file and analyzed.
  
  
  RESULTS
  Of the 1427 patients who underwent nose reconstruction or rhinoplasty in this study, 565 (39.56 percent) received alar rim grafts. This included 73 primary nose reconstructions, 20 secondary nose reconstructions, two revision nose reconstructions, 304 primary rhinoplasties, 107 secondary rhinoplasties, 43 revision operations following primary rhinoplasties, and seven revision operations following secondary rhinoplasties. However, when 100 more recent consecutive cases were reviewed, 88 percent of primary rhinoplasty patients and 67 percent of secondary rhinoplasty patients received alar rim grafts. The observed dynamic changes after insertion of each graft included (1) correction of the concavity of the ala, (2) caudal advancement of the alar rim, (3) elongation of nostril, and (4) widening of the nostril.
  
  
  CONCLUSIONS
  The majority of patients who undergo rhinoplasty would benefit from the alar rim graft, and this study demonstrates a steady increase in its use. Placement of an alar rim graft results in elongation of the short nostril, correction of the alar concavity, widening of the nostril, and slight caudal transposition of the alar rim.
authors.affiliation: Cleveland, Ohio; and Newport Beach, Calif. From the Department of Plastic Surgery, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine; and private practice.
authors.forename: Bahman
authors.initials: B
authors.lastname: Guyuron
authors.forename: Yaas
authors.initials: Y
authors.lastname: Bigdeli
authors.forename: Ali
authors.initials: A
authors.lastname: Sajjadian
mesh_terms: D002356:Cartilage / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D012086:Reoperation; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*