New Classification for Correction of Alar Retraction Using the Alar Spreader Graft

Kim, Jae-Hoon; Park, Sung Wan; Oh, Won Suk; Lee, Joo Heon

doi:10.1007/s00266-012-9901-6

Cited by 22 publications

(36 citation statements)

References 10 publications

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“…In particular, nasal septum extension and several different columella graft methods are performed to improve the less-projected nasal tip and retracted columella, 18 and alar spreader and nasal tip grafts were used to improve retracted nasal alar cartilages. 19 Likewise, surgeries using various autogenous tissues with various tip plasty procedures have overcome several limitations in recent years, resulting in remarkable developments.…”

Section: Discussionmentioning

confidence: 99%

Various Applications of Deep Temporal Fascia in Rhinoplasty

et al. 2015

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PurposeIn Asians, nasal dorsal and tip augmentation procedures are usually performed at the same time, and most dorsal augmentations use implants. In this study, dorsal augmentation was given by various types of grafts using deep temporal fascia (DTF) for primary rhinoplasty cases using only autologous tissues to improve the curve of hump noses and depressions. For secondary rhinoplasty cases, DTF was used to improve implant demarcation and transparency. Such effectiveness and utility of DTF is discussed.Materials and MethodsBetween May 2009 and May 2012, we performed rhinoplasty using DTF in 175 patients, which included 78 secondary surgery patients and 128 female patients. The mean age of the patients was 31.4. DTF was utilized with various types of grafts without implants to improve the curve in dorsal augmentation of hump noses and cases that required curve betterment. DTF was used to improve implant demarcation and transparency for secondary cases.ResultsThe mean follow-up duration was 1.5 years. Of the 175 patients, 81% were satisfied with the natural correction achieved, whereas 19% complained of undercorrection, which was resolved with additional surgery. No specific complications such as nasal inflammation or contractures were observed.ConclusionDTF can be used with various graft methods for correction of radix, dorsal, and tip irregularities. It can also be used to correct implant contour transparency in secondary rhinoplasty and thus may be considered as a useful supplementary graft material in rhinoplasty for Asians.

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Section: Discussionmentioning

confidence: 99%

Various Applications of Deep Temporal Fascia in Rhinoplasty

et al. 2015

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“…From the point of view of harvesting of the graft, we considered the type of alar retraction. According to Kim et al [9], alar retraction can be classified as medial, central, or lateral. We made an incision or trimmed the skin paddle based on the type of the alar retraction, with reference to the classification of Kim et al [9].…”

Section: Discussionmentioning

confidence: 99%

“…According to Kim et al [9], alar retraction can be classified as medial, central, or lateral. We made an incision or trimmed the skin paddle based on the type of the alar retraction, with reference to the classification of Kim et al [9]. Doing so yielded better aesthetic outcomes of the postoperative shape of the alar rim.…”

Section: Discussionmentioning

confidence: 99%

“…Using curved Metzenbaum scissors, the skin was trimmed to expose the underlying cartilage. In this process, we made an incision or trimmed the skin based on the type of the alar retraction, with reference to the classification of Kim et al [9], who classified alar retraction as medial, central, or lateral. The donor site was anesthetized with 1% lidocaine with diluted epinephrine.…”

Section: Donor Site Identification and Harvestmentioning

confidence: 99%

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Alar Rim Composite Graft: A Safe and Simple Way to Correct Alar Retraction

Chun

Yoon

Wee

et al. 2018

Arch Aesthetic Plast Surg

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Background The alar rim is a complex structure that ensures the competence of the external valves and the patency of inlets to the nasal airways. Retraction of the alar rim is caused by congenital malpositioning, hypoplasia, or surgical weakening of the lateral crura, with the potential for both functional and aesthetic ramifications. Most previously introduced procedures involved a relatively long operation time and relatively high risks of surgical complications. The purpose of this study is to introduce a novel surgical technique for alar rim connection and to present its results. Methods After marking the extent of the correction, the recipient alar bed was created by making an incision through the vestibular skin 2-mm cephalad to the rim. Then, the composite graft was harvested from the cymba concha by removing the cartilage with its adherent anterior skin. According to the degree of retraction, the harvested composite graft was divided into 2 pieces considering the symmetry of both alar rims. The composite grafts were inserted into the defects and primary closure was done at the donor site. Results Our surgical technique was used to correct 12 retracted alar rims in 6 patients. Caudal advancement of the alar rims was observed and the contour of the ala was corrected in all 6 patients. The mean length of follow-up was 1-year, and there were no postoperative complications, such as graft loss or disruption. Conclusions The alar rim composite graft is a safe and simple technique for correction of short nostril and caudal transposition of the retracted alar rim.

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“…Of interest, therefore, is which lower nasal base structures are actually released when alar release is performed. In a study involving the senior author of this Commentary (RPG), 18 it appeared that the pyriform ligament (a type of "fascial membrane")-described by Rohrich et al 19 and discussed by others 20,21 -directly or indirectly helped maintain the position of the alar base. However, having rediscovered the structural integrity of tela subcutanea cutis, Daniel et al understandably question the existence of any "ligaments" from the pyriform aperture to components of the alar Figure 1.…”

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confidence: 99%