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Nasal Base Retraction: A Treatment Algorithm.

Süleyman Tas1, Salih Colakoglu1, Bernard Travis Lee1

  • 1Dr Tas is an Assistant Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery, Medicalpark Gaziosmanpasa Hospital, Istanbul Kemerburgaz University, Istanbul, Turkey. Dr Colakoglu is Chief Resident, Division of General Surgery, Department of Surgery, New York Presbyterian Queens, Weill Cornell Medical College, New York, NY, USA. Dr Lee is an Associate Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

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Summary

This study introduces a new algorithm for treating nasal base retraction, a common cause of facial disharmony. The developed treatment effectively improved both aesthetic symmetry and nasal breathing in patients undergoing rhinoplasty.

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Area of Science:

  • Plastic Surgery
  • Facial Aesthetics
  • Rhinology

Background:

  • Nasal base retraction, caused by vertical malposition of the alar base, creates disharmony with other nasal structures.
  • Correction is crucial for aesthetic improvement, yet literature on this deformity is limited.

Purpose of the Study:

  • To develop a treatment algorithm for nasal base retraction based on a severity classification system.
  • To guide rhinoplasty surgeons in achieving improved aesthetic and functional outcomes.

Main Methods:

  • Retrospective case review of 53 patients undergoing rhinoplasty with alar base retraction correction.
  • Procedures included levator labii alaque nasi muscle dissection or alar base release, with or without rim grafts, based on severity.
  • Aesthetic outcomes assessed via objective grading of photographs; functional improvement by patient self-evaluation and ROE questionnaire.

Main Results:

  • Significant improvement in nasal base asymmetry, with 85% achieving complete symmetry.
  • Marked reduction in nasal obstruction (P < 0.001).
  • High patient satisfaction (92.5%) with ROE scores indicating positive outcomes.

Conclusions:

  • The study presents novel techniques and a treatment algorithm for nasal base retraction deformities.
  • This approach aids surgeons in achieving aesthetically and functionally superior results in rhinoplasty patients.