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Simultaneous open rhinoplasty and alar base excision for secondary cases
Ali Teoman Tellioğlu1, Ibrahim Vargel, Tarik Cavuşoğlu
1Ali Teoman Tellioğlu, Kenedi Cad 61/8, Kavaklidere, Ankara, 06660, Turkey. tellioglu22@hotmail.com
Aesthetic Plastic Surgery
|June 17, 2005
Summary
Simultaneous open rhinoplasty with alar base excision is safe for secondary cases. However, prior surgical techniques can compromise nasal tip blood supply, necessitating caution and potential deferral of alar base excision.
Area of Science:
- Plastic Surgery
- Facial Reconstructive Surgery
Background:
- Simultaneous open rhinoplasty and alar base excision is generally safe for primary cases.
- Secondary rhinoplasty cases present higher risks due to scar tissue and altered vascularity.
- Assessing the risk of nasal tip and columellar skin necrosis in secondary cases is crucial.
Purpose of the Study:
- To evaluate the safety and risks of simultaneous open rhinoplasty and alar base excision in patients undergoing secondary procedures.
- To identify factors that may compromise nasal tip and columellar skin vascularity in revision rhinoplasty.
Main Methods:
- A cohort of 12 patients (6 male, 6 female) with an average age of 27 underwent the procedure over 3 years.
- Follow-up averaged 15 months.
- A modified grading system assessed vascular supply to the nasal tip and columella.
Main Results:
- One patient experienced Grade 3 vascular compromise to the nasal tip and columella.
- This patient healed successfully with wound care.
- Overall, satisfactory results were achieved in the majority of cases.
Conclusions:
- Simultaneous alar base excision and open rhinoplasty can be safely performed in secondary cases.
- Previous surgical maneuvers (e.g., tip grafting, defatting, scarring) can disrupt nasal vascular supply.
- In such instances, alar base excision should be deferred as a separate procedure.