Intermediate alar resection: Precision technique for nasal tip aesthetics

To evaluate the effectiveness of a newly described rhinoplasty technique, Intermediate Alar Resection (IAR), designed to refine the nasal tip by selectively modifying the intermediate crura.

A retrospective cohort of 52 patients undergoing primary rhinoplasty with IAR between January 2024 and June 2025 was analysed. Standardised preoperative and postoperative photographs were assessed for nasolabial and nasofacial angles, Goode's ratio, nasal projection, and tip width. Patient satisfaction was measured using the Rhinoplasty Outcome Evaluation (ROE) questionnaire, a validated six-item instrument scored from 0 to 24.

Postoperative analysis demonstrated significant improvements in nasal tip parameters. The median nasolabial angle increased from 97.1° to 105.6° (p < 0.001) and the nasofacial angle from 35.6° to 37.9° (p < 0.001). Tip width decreased by 12% on average, while nasal projection decreased by 7.5%. Goode's ratio remained stable. Patient-reported outcomes indicated high satisfaction, with a median postoperative ROE score of 22 (IQR: 2) out of a maximum of 24, and no major complications were observed.

Intermediate Alar Resection allows targeted modification of the intermediate crura, achieving predictable improvements in nasal tip projection, rotation, and definition. The technique is safe, effective, and associated with high patient satisfaction, offering a valuable addition to rhinoplasty methods.