Components of the short nostril

Area of Science:

• Plastic Surgery
• Facial Plastic Surgery
• Rhinoplasty

Background:

• Short nostril is a complex nasal deformity requiring evaluation beyond simple alar/columellar issues.
• The soft triangle is a critical component in short nostril disharmony, alongside the alar rim and surrounding cartilaginous structures.

Purpose of the Study:

• To examine the role of soft triangle excision and other surgical techniques in correcting the short nostril deformity.
• To identify key anatomical landmarks and their influence on treatment strategies for short nostrils.

Main Methods:

• Retrospective review of 200 rhinoplasties (primary and secondary).
• Analysis of 27 patients who underwent soft triangle excision, with or without modification of other nasal structures.
• Evaluation of the distance from the nostril apex to the caudal border of the alar dome as a defining factor.

Main Results:

• The distance from the nostril apex to the caudal alar dome dictates the surgical approach.
• Soft triangle excision effectively elongates the nostril when this distance is excessive.
• Transdomal sutures, interdomal sutures, columellar struts, and alar rim grafts can also improve nostril length and aesthetics.

Conclusions:

• Soft triangle tissue extent is the most critical factor in short nostril analysis and treatment.
• Soft triangle lining removal is indicated for excessive nostril apex to caudal dome distance, allowing anterior repositioning and elongation.
• A comprehensive approach addressing coexisting nasal base and tip abnormalities is essential for optimal outcomes.