Modified Technique for Simultaneous Alar Base Narrowing and Nostril Reduction in Asian Rhinoplasty: With a Video...

Area of Science:

• Plastic Surgery
• Rhinoplasty
• Aesthetic Surgery

Background:

• Conventional alar base excision often results in visible scarring and unnatural nostril deformities.
• There is a need for improved surgical techniques for alar base reduction and nostril refinement, particularly in Asian populations.

Purpose of the Study:

• To describe and evaluate a modified combined sill and alar excision technique.
• To assess the aesthetic outcomes, scar visibility, and complication rates of this modified technique.

Main Methods:

• The modified technique involves precise incision placement within the alar-facial groove and closure with intracutaneous sutures.
• Key steps include preoperative marking, customized resection, medial alar flap rotation, and layered closure.
• Outcome measures included interalar-to-intercanthal distance ratio, nostril shape/symmetry assessment, Visual Analog Scale (VAS) for scarring, and complication incidence.

Main Results:

• A significant reduction in the interalar-to-intercanthal distance ratio was observed.
• Marked decrease in horizontal nostril configuration and a significant increase in ideal pear-shaped nostrils.
• Improved nostril symmetry, with most patients reporting imperceptible scars (low VAS scores).
• No alar deformities, infections, or hypertrophic scarring were reported.

Conclusions:

• The modified combined sill and alar excision technique is a safe, effective, and reproducible method for alar base narrowing and nostril refinement in Asian patients.
• This technique yields predictable aesthetic results, minimizes visible scarring, and creates harmonious, natural-looking nostril geometry.