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J Cosmet Med 2021; 5(1): 49-52

Published online June 30, 2021

https://doi.org/10.25056/JCM.2021.5.1.49

Correction of nostril show

Sung Il Cho , MD, PhD , Junghyun Oh , MD, PhD , Ji Yun Choi , MD, PhD

Department of Otolaryngology-Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Rep. of Korea

Correspondence to :
Ji Yun Choi
E-mail: happyent@naver.com

Received: October 21, 2020; Revised: November 23, 2020; Accepted: November 23, 2020

© Korean Society of Korean Cosmetic Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

A majority of alar rim deformity cases arises from the procedural complications of rhinoplasty. However, an increasing interest in the aesthetic aspects of alar rim deformity has led patients with congenitally retracted or hanging alae to seek revision surgeries. Alar retraction is predominantly caused by an excessive cephalic orientation or overmedialization of the lower lateral cartilage and a lack of soft tissue around the alar rim. The aim of this article is to present the case of a 59-year-old female patient with retracted alae from cephalically malpositioned lower lateral cartilages. We addressed these by using an external rhinoplasty approach to separate lower lateral cartilage from the surrounding tissues and apply an alar spreader graft and intergrated lateral crural strut graft to effectively correct the nostril show without any significant adverse effects.

Keywords: correction, nostril, retraction, rhinoplasty

Fig. 1.Preoperative photo of frontal view shows severe nostril show, alar asymmetry and weak nasal tip.
  1. Lee JE, Choi JY. Diagnosis and treatment of alar rim deformities. Korean J Otorhinolaryngol-Head Neck Surg 2016;59:9-14.
    CrossRef
  2. Gunter JP, Rohrich RJ, Friedman RM. Classification and correction of alar-columellar discrepancies in rhinoplasty. Plast Reconstr Surg 1996;97:643-8.
    Pubmed CrossRef
  3. Jung DH, Kwak ES, Kim HS. Correction of severe alar retraction with use of a cutaneous alar rotation flap. Plast Reconstr Surg 2009;123:1088-95.
    Pubmed CrossRef
  4. Toriumi DM. Nasal tip contouring: anatomic basis for management. Facial Plast Surg Aesthet Med 2020;22:10-24.
    Pubmed CrossRef
  5. Constantian MB. The boxy nasal tip, the ball tip, and alar cartilage malposition: variations on a theme--a study in 200 consecutive primary and secondary rhinoplasty patients. Plast Reconstr Surg 2005;116:268-81.
    Pubmed CrossRef
  6. Rohrich RJ, Raniere J Jr, Ha RY. The alar contour graft: correction and prevention of alar rim deformities in rhinoplasty. Plast Reconstr Surg 2002;109:2495-505; discussion 2506-8.
    Pubmed CrossRef
  7. Guyuron B. Alar rim deformities. Plast Reconstr Surg 2001;107:856-63.
    Pubmed CrossRef
  8. Tardy ME Jr, Toriumi D. Alar retraction: composite graft correction. Facial Plast Surg 1989;6:101-7.
    Pubmed CrossRef
  9. Gunter JP, Friedman RM. Lateral crural strut graft: technique and clinical applications in rhinoplasty. Plast Reconstr Surg 1997;99:943-52; discussion 953-5.
    Pubmed CrossRef
  10. Kim HS, Roh SG. The alar extension graft for retracted ala. J Korean Soc Plast Reconstr Surg 2009;36:66-74.
  11. Gruber RP, Kryger G, Chang D. The intercartilaginous graft for actual and potential alar retraction. Plast Reconstr Surg 2008;121:288e-96e.
    Pubmed CrossRef
  12. Kim DY, Kim IS, Jin HR. Frequently used grafts in Korean rhinoplasty: nomenclature and definitions. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:412-8.
    CrossRef
  13. Choi JY, Javidnia H, Sykes JM. New techniques for correction of severe alar retraction using an island pedicled advancement flap of the nasal dorsum. J Plast Reconstr Aesthet Surg 2013;66:1803-4.
    Pubmed CrossRef
  14. Kim JH, Park SW, Oh WS, Lee JH. New classification for correction of alar retraction using the alar spreader graft. Aesthetic Plast Surg 2012;36:832-41.
    Pubmed CrossRef
  15. Paik MH, Chu LS. Correction of the short nose using derotation graft. Arch Aesthetic Plast Surg 2012;18:35-44.
  16. Kao WTK, Davis RE. Postsurgical alar retraction: etiology and treatment. Facial Plast Surg Clin North Am 2019;27:491-504.
    Pubmed CrossRef

Article

Case Report

J Cosmet Med 2021; 5(1): 49-52

Published online June 30, 2021 https://doi.org/10.25056/JCM.2021.5.1.49

Copyright © Korean Society of Korean Cosmetic Surgery.

Correction of nostril show

Sung Il Cho , MD, PhD , Junghyun Oh , MD, PhD , Ji Yun Choi , MD, PhD

Department of Otolaryngology-Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Rep. of Korea

Correspondence to:Ji Yun Choi
E-mail: happyent@naver.com

Received: October 21, 2020; Revised: November 23, 2020; Accepted: November 23, 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A majority of alar rim deformity cases arises from the procedural complications of rhinoplasty. However, an increasing interest in the aesthetic aspects of alar rim deformity has led patients with congenitally retracted or hanging alae to seek revision surgeries. Alar retraction is predominantly caused by an excessive cephalic orientation or overmedialization of the lower lateral cartilage and a lack of soft tissue around the alar rim. The aim of this article is to present the case of a 59-year-old female patient with retracted alae from cephalically malpositioned lower lateral cartilages. We addressed these by using an external rhinoplasty approach to separate lower lateral cartilage from the surrounding tissues and apply an alar spreader graft and intergrated lateral crural strut graft to effectively correct the nostril show without any significant adverse effects.

Keywords: correction, nostril, retraction, rhinoplasty

Fig 1.

Figure 1.Preoperative photo of frontal view shows severe nostril show, alar asymmetry and weak nasal tip.
Journal of Cosmetic Medicine 2021; 5: 49-52https://doi.org/10.25056/JCM.2021.5.1.49

References

  1. Lee JE, Choi JY. Diagnosis and treatment of alar rim deformities. Korean J Otorhinolaryngol-Head Neck Surg 2016;59:9-14.
    CrossRef
  2. Gunter JP, Rohrich RJ, Friedman RM. Classification and correction of alar-columellar discrepancies in rhinoplasty. Plast Reconstr Surg 1996;97:643-8.
    Pubmed CrossRef
  3. Jung DH, Kwak ES, Kim HS. Correction of severe alar retraction with use of a cutaneous alar rotation flap. Plast Reconstr Surg 2009;123:1088-95.
    Pubmed CrossRef
  4. Toriumi DM. Nasal tip contouring: anatomic basis for management. Facial Plast Surg Aesthet Med 2020;22:10-24.
    Pubmed CrossRef
  5. Constantian MB. The boxy nasal tip, the ball tip, and alar cartilage malposition: variations on a theme--a study in 200 consecutive primary and secondary rhinoplasty patients. Plast Reconstr Surg 2005;116:268-81.
    Pubmed CrossRef
  6. Rohrich RJ, Raniere J Jr, Ha RY. The alar contour graft: correction and prevention of alar rim deformities in rhinoplasty. Plast Reconstr Surg 2002;109:2495-505; discussion 2506-8.
    Pubmed CrossRef
  7. Guyuron B. Alar rim deformities. Plast Reconstr Surg 2001;107:856-63.
    Pubmed CrossRef
  8. Tardy ME Jr, Toriumi D. Alar retraction: composite graft correction. Facial Plast Surg 1989;6:101-7.
    Pubmed CrossRef
  9. Gunter JP, Friedman RM. Lateral crural strut graft: technique and clinical applications in rhinoplasty. Plast Reconstr Surg 1997;99:943-52; discussion 953-5.
    Pubmed CrossRef
  10. Kim HS, Roh SG. The alar extension graft for retracted ala. J Korean Soc Plast Reconstr Surg 2009;36:66-74.
  11. Gruber RP, Kryger G, Chang D. The intercartilaginous graft for actual and potential alar retraction. Plast Reconstr Surg 2008;121:288e-96e.
    Pubmed CrossRef
  12. Kim DY, Kim IS, Jin HR. Frequently used grafts in Korean rhinoplasty: nomenclature and definitions. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:412-8.
    CrossRef
  13. Choi JY, Javidnia H, Sykes JM. New techniques for correction of severe alar retraction using an island pedicled advancement flap of the nasal dorsum. J Plast Reconstr Aesthet Surg 2013;66:1803-4.
    Pubmed CrossRef
  14. Kim JH, Park SW, Oh WS, Lee JH. New classification for correction of alar retraction using the alar spreader graft. Aesthetic Plast Surg 2012;36:832-41.
    Pubmed CrossRef
  15. Paik MH, Chu LS. Correction of the short nose using derotation graft. Arch Aesthetic Plast Surg 2012;18:35-44.
  16. Kao WTK, Davis RE. Postsurgical alar retraction: etiology and treatment. Facial Plast Surg Clin North Am 2019;27:491-504.
    Pubmed CrossRef

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