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July 1996

Alar Reductions in Rhinoplasty

Author Affiliations

From the Department of Otolaryngology, The University of Oklahoma Health Sciences Center, Tulsa.

Arch Otolaryngol Head Neck Surg. 1996;122(7):781-784. doi:10.1001/archotol.1996.01890190077017

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.Arch Otolaryngol Head Neck Surg. 1996;122:781-784

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