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Alar cartilage replacement a suitable alternative for nasal tip reconstruction

In a retrospective review of rhinoplasty revisions, researchers found the complete replacement of alar cartilages was an efficient surgical option for nasal tip reconstruction.

Of the 569 revision patients included in the review, 20 (3.5%) underwent anatomic reconstruction for either severely damaged alar cartilages or excessive alar asymmetry at their lateral borders. Other grafts used included eight columellar struts, six onlay grafts and three spreader grafts. All patients underwent preoperative inspection of the columella, nostril margin, alar rim and tip lobule.

During the procedure, nasal tip distortion was anatomically diagnosed and, depending on the status of alar cartilage, residual alar cartilage was either resected or left untouched to provide additional support. The ear cartilage grafts were harvested and molded, sutured and affixed to the remnant cartilage.

The researchers reported that, ideally, each alar graft length should range from 35 mm to 40 mm, and alar graft width should be between 5 mm and 6 mm at the dome and about 8 mm to 9 mm at the distal portion of the lateral pairs.

At a mean 24-month follow-up, all patients reported satisfaction with their outcomes and improvement in functional symptoms. No complications were reported, and no further revision surgeries were necessary, according to the researchers. – by Abigail Sutton

Disclosures: The authors reported no relevant financial disclosures.