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Alar retraction can result in an unfavorable appearance, as well as leading to collapse of the external nasal valve and accompanying nasal obstruction. Alexander and colleagues conducted a retrospective review of 520 rhinoplasty patients from 2002 through 2005 to further clarify the etiology and treatment of alar retraction. The authors identified 45 patients with alar retraction and report that composite grafting is the most successful treatment for alar retraction (95% correction rate). An algorithm for the treatment of alar retraction is presented at the end of the article.
Correction of the saddle nose deformity presents a challenge to rhinoplasty surgeons, and considerable debate still remains regarding the best techniques to correct it. Hyun and Jang conducted a retrospective review of 91 patients treated for a saddle nose deformity to elucidate the best treatment and characterize treatment outcomes. The authors report that the majority of patients studied achieved an excellent or good appearance postoperatively; however, 22% of patients still had fair to poor outcomes, with a 9% revision rate. A new classification scheme for the varieties of saddle nose deformity is presented.
Infantile hemangiomas are the most common tumor of infancy and most commonly occur in the head and neck. O and colleagues performed a retrospective review of 342 patients diagnosed with infantile hemangiomas of the lips over a 7-year period (2004-2011). The authors report that focal lesions at the lower lip were most commonly encountered. Segmental lesions most commonly involved the mandibular segment (V3). Varying approaches to surgical management are discussed.
Facial reanimation presents significant challenges to the reconstructive surgeon. The workhorse of dynamic facial reanimation has traditionally been the gracilis free flap; however, the gracilis flap is not without disadvantages such as bulk. Alam and colleagues present a preclinical feasibility study of the sternohyoid muscle and its potential use in facial reanimation. The authors report predictable and reliable arterial and venous pedicles, as well as a long motor nerve length that may allow for single-stage cross-facial neurorrhaphies.
Highlights. JAMA Facial Plast Surg. 2013;15(4):245. doi:10.1001/jamafacial.2013.1550