Nasal sill augmentation: an overlooked concept in rhinoplasty—a technical note and review of the literatures

Abstract

Background Nasal sill is one of the components of the alar ring, affecting the esthetic outcomes of rhinoplasty; accordingly, we developed a novel technique to adjust defects in this area and compared it with the available techniques. Methods Our technique was based on creating a tunnel access to the nasal sill area through an incision made in the lower third of the columella using the open approach or through a nostril base incision in patients, who underwent alar base reduction, followed by insertion of a cartilaginous graft into the marked defect area. Results A total number of 54 patients with a defect in the nasal sill area were included in this study. Thirty-one patients underwent open rhinoplasty with the sill approach from the lower third of the columella, while 23 patients underwent rhinoplasty with a nostril base approach for nasal sill augmentation procedure. There were no reports of patient dissatisfaction, infection, bleeding, sensory dysfunction, or remaining asymmetry of the sill area. Conclusion Based on the findings of the present study, this technique can be successfully used in reconstructing the nasal sill area with minimal complications and morbidity.

Rhinoplasty Technique for Improving Nasal Base Aesthetics

“…Adham et al 16 published their article related to the augmentation of nasal sill defects. The technique they proposed may be particularly useful in patients with cleft lip.…”

Alar Base Reduction with Y-V Sill Flap

“…The alar bases have important roles in terms of overall appearance of the nose and the functionality3 but the research so far which focused specifically on alar base surgery can be considered as insufficient 4. However, it has been reported that alar base was manipulated between the ranges of 15% and 90% during rhinoplasty surgeries 5…”