title: Simple Correction of Alar Retraction by Conchal Cartilage Extension Grafts.
abstract: BACKGROUND
  Alar retraction is a challenging condition in rhinoplasty marked by exaggerated nostril exposure and awkwardness. Although various methods for correcting alar retraction have been introduced, none is without drawbacks. Herein, we report a simple procedure that is both effective and safe for correcting alar retraction using only conchal cartilage grafting.
  
  
  METHODS
  Between August 2007 and August 2009, 18 patients underwent conchal cartilage extension grafting to correct alar retraction. Conchal cartilage extension grafts were fixed to the caudal margins of the lateral crura and covered with vestibular skin advancement flaps. Preoperative and postoperative photographs were reviewed and analyzed. Patient satisfaction was surveyed and categorized into 4 groups (very satisfied, satisfied, moderate, or unsatisfied).
  
  
  RESULTS
  According to the survey, 8 patients were very satisfied, 9 were satisfied, and 1 considered the outcome moderate, resulting in satisfaction for most patients. The average distance from the alar rim to the long axis of the nostril was reduced by 1.4 mm (3.6 to 2.2 mm). There were no complications, except in 2 cases with palpable cartilage step-off that resolved without any aesthetic problems.
  
  
  CONCLUSIONS
  Conchal cartilage alar extension graft is a simple, effective method of correcting alar retraction that can be combined with aesthetic rhinoplasty conveniently, utilizing conchal cartilage, which is the most similar cartilage to alar cartilage, and requiring a lesser volume of cartilage harvest compared to previously devised methods. However, the current procedure lacks efficacy for severe alar retraction and a longer follow-up period may be required to substantiate the enduring efficacy of the current procedure.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yong Jun
authors.initials: YJ
authors.lastname: Jang
authors.affiliation: Imi Plastic and Aesthetic Surgery Clinic, Seoul, Korea.
authors.forename: Sung Min
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Dae Hyun
authors.initials: DH
authors.lastname: Lew
authors.affiliation: Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seung Yong
authors.initials: SY
authors.lastname: Song
keywords: Ear cartilage; Nose; Rhinoplasty; Transplants