title: Alar Contour Grafts in Rhinoplasty: A Safe and Reproducible Way to Refine Alar Contour Aesthetics.
abstract: BACKGROUND
  Alar rim deformities such as retraction, notching, collapse, and asymmetry are common problems in rhinoplasty patients. Although alar rim deformities may be improved through rhinoplasty, this area is prone to late changes because of scarring of the soft triangles and a paucity of native structural support. The purpose of this study was to analyze the effect of alar contour grafts on primary rhinoplasty.
  
  
  METHODS
  Fifty consecutive primary rhinoplasty patients with preoperative and postoperative photographs who received alar contour grafts were evaluated for alar aesthetics; 50 consecutive primary rhinoplasty patients without such grafts served as controls. Differences among alar retraction, notching, collapse, and asymmetry from anterior, lateral, and basal views were evaluated. Follow-up ranged from 1 to 4 years and was graded on a four-point scale.
  
  
  RESULTS
  The average difference between the two groups' aggregate preoperative scores was 0.21 (p = 0.24). The average preoperative and postoperative scores in the nongraft group were significant for worsening retraction, notching, and collapse but insignificant for asymmetry. The preoperative and postoperative scores for the graft group were insignificant for retraction but improved significantly for notching, collapse, and asymmetry. Postoperatively, the aggregate average of the scores in the nongroup was 0.32 points worse (p < 0.01), whereas the graft group had a 0.33-point improvement (p < 0.01).
  
  
  CONCLUSIONS
  Alar contour grafts have a clear and important impact on cosmetic results of primary rhinoplasty. Use of alar contour grafts has been shown to improve aesthetics, whereas there is a worsening of the measured parameters postoperatively without use of these grafts.
  
  
  METHODS
  Therapeutic, III.
authors.affiliation: Dallas, Texas From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Jacob G
authors.initials: JG
authors.lastname: Unger
authors.forename: Jason
authors.initials: J
authors.lastname: Roostaeian
authors.forename: Kevin H
authors.initials: KH
authors.lastname: Small
authors.forename: Ronnie A
authors.initials: RA
authors.lastname: Pezeshk
authors.forename: Michael R
authors.initials: MR
authors.lastname: Lee
authors.forename: Ryan
authors.initials: R
authors.lastname: Harris
authors.forename: Rod J
authors.initials: RJ
authors.lastname: Rohrich
mesh_terms: D000328:Adult; D016208:Databases, Factual; D004954:Esthetics; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D055171:Nasal Cartilages / Q000503:physiopathology* / Q000601:surgery*; D017060:Patient Satisfaction; D010781:Photography / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000009:adverse effects / Q000379:methods*; D018570:Risk Assessment; D055815:Young Adult