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Alar reductions in rhinoplasty
1Department of Otolaryngology, University of Oklahoma Health Sciences Center, Tulsa, USA.
Objective:
To ascertain if avoiding the vestibular portion of alar reductions during rhinoplasty could improve the cosmetic result of the postoperative nasal sill.
Design:
Blind, randomized review of base-view photographs (40 patients) 1 year after rhinoplasty.
Setting:
A surgical clinic, accredited by the Accreditation Association of Ambulatory Health Care.
Participants:
A consecutive sample of 40 patients (2 groups) who underwent alar reduction as a part of their rhinoplasty and whose 1-year postoperative photographs were reviewed by 2 facial plastic surgeons and 3 plastic surgeons.
Main Outcome Measures:
Midway through a 2-year period, the method of alar reduction was changed to include only the cutaneous portion of the nostril. Twenty-two patients had cutaneous-vestibular excisions; 18 patients had cutaneous-only excisions. The surgeon participants reviewed randomized photographs taken 1 year postoperatively and were asked to rate the alar sill for the degree of scarring and notching.
Results:
Tabulation of the surgeons' ratings revealed significantly less perception of notching and scarring in the alar reduction group with the cutaneous-only excisions.
Conclusion:
Modification of alar reduction to avoid crossing the nostril rim appears to improve the aesthetic result.