This article is more than 5 years old. Information may no longer be current.

Repositioning of lateral cartilages significantly lowers alar rim

There was a statistically significant lowering of the alar rim when lower lateral cartilages were repositioned, according to study results recently published in JAMA Facial Plastic Surgery.

Researchers conducted a retrospective review of 54 patients (102 hemi-noses; 79% women; average age, 41.36 years) who underwent lateral crural repositioning by the same surgeon between 2007 and 2013. Patients had standardized photographs taken preoperatively and at least 6 months postoperatively.

The degree of alar rim retraction on lateral views was measured on the photographs using Adobe Photoshop CS via a modified Gunter technique, with change in angle calculated. A paired t test was used to conduct statistical analysis.

Revision rhinoplasties were the most common procedure (83%), with 11.3 months being the average time to obtaining postoperative photographs. A net decrease of 6.8 degrees was indicated by mean anterior nostril apex angles of 31.3° preoperatively and 24.5° postoperatively (P < .001).

“Excluding patients who had other rim-lowering grafts (alar rim and/or composite grafts), we saw a similar result comparing preoperative and postoperative angles, with a net decrease of 6.5° (P < .001),” the researchers wrote.

The decrease for patients who had lateral crural repositioning alone was 6.9° compared with 6.7° for those who had lateral crural strut grafts (P <.001, both).

“Repositioning the lateral crura is an extremely powerful maneuver in modern rhinoplasty,” the researchers concluded. “The [study] results demonstrate that repositioning the lower lateral cartilages with or without a lateral crural strut graft into a more caudal pocket results in a statistically significant lowering of the alar rim.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.