Alar Base Lift with an Alar Base Rotation Flap

Area of Science:

• Plastic Surgery
• Aesthetic Surgery
• Facial Plastic Surgery

Background:

• Hanging alae is a prevalent aesthetic concern in Southeast Asian populations, characterized by alar overhang and a "heavy hypertrophic alar" appearance.
• Alar lift surgery is crucial in rhinoplasty but often underestimated, with potential complications including visible scarring and disruption of anatomical junctions.
• The alar base rotation flap (ABRF) technique aims to mitigate these issues by hiding incisions and reducing wound healing tension.

Purpose of the Study:

• To evaluate the efficacy of the alar base rotation flap (ABRF) in correcting hanging alae and improving the alar-columellar relationship (ACR).
• To assess the aesthetic outcomes and patient satisfaction following alar base lift surgery using the ABRF technique.

Main Methods:

• The study involved patients undergoing alar base lift with the alar base rotation flap (ABRF) after vertical reduction and lift of the lateral ala.
• The basal defect was repaired using a small rotation flap along the nasolabial fold.
• Pre- and post-operative 2D photometric evaluations were conducted to quantify aesthetic changes.

Main Results:

• No compromise in nasal tip circulation was observed post-surgery.
• All patients demonstrated good wound healing with minimal scarring and an improved alar-columellar relationship (ACR).
• Significant reductions were noted in the vertical alar base distance index (3.38%) and alar columellar angle (15.8°), both with p < 0.005.

Conclusions:

• Alar base lift utilizing the alar base rotation flap (ABRF) is an effective method for enhancing the alar-columellar relationship.
• The ABRF technique provides an elevated alar base position with a cosmetically acceptable, less visible scar.
• This surgical approach offers a valuable solution for patients with hanging alae seeking improved nasal aesthetics.