The Subalar Graft and Its Role in Nasal Tip Medialization and Improved Nostril Symmetry

Aynehchi, Behrad B.; Mascaró, Miguel; Rosenfeld, Richard M.; Westreich, Richard W.

doi:10.1177/0194599813505843

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…Although a previous study showed a significant improvement in nasal axis deviation, alar facial angle on base view, and alar facial angle on frontal view with the subalar graft, 2 this study with a larger cohort confirmed these findings. In this cohort, there was also a change in commissure angle on frontal view, although this was a less dramatic change.…”

Section: Discussionsupporting

confidence: 63%

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The Utility of the Subalar Graft in Nostril Symmetry in Rhinoplasty

Lee

Luo

et al. 2021

Plastic &Amp; Reconstructive Surgery

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Background: A deviated nose can be attributable to multiple anatomical factors, including asymmetric maxilla. A subalar graft helps to correct maxillary hypoplasia and may be a useful tool for correcting a deviated nose. The authors' objective is to show the effects of the subalar graft in improving nostril symmetry and to propose an algorithm for using this graft in open and endonasal rhinoplasty. Methods: A retrospective case series was performed on patients who had undergone rhinoplasty performed by the senior author (R.W.) from September of 2008 to July of 2015. Patients with at least 3 months of follow-up and adequate photographs were included. The mean follow-up period was 11.0 months (range, 3 to 72 months). A total of 68 patients were included. Preoperative and postoperative photographs were analyzed to measure changes in nasal axis deviation, alar facial angle on base view, alar facial angle on frontal view, and nostril show bilaterally. Results: Of the 68 patients, statistically significant improvement of nasal axis deviation of 4.32 degrees toward the midline was observed. Alar facial angle on base view was improved 1.01 degrees toward the horizontal. Nostril symmetry also improved based on the ratio between the shorter side and the longer side. The mean change in nostril show ratio was 0.19 toward a 1:1 ratio. Conclusions: Previous studies have shown that the subalar grafting technique is an important adjunctive technique in rhinoplasty for patients with midfacial asymmetries. This case series demonstrates that this technique can provide sustained results in the correction of the nasal foundation.

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Section: Discussionsupporting

confidence: 63%

“…Previous studies on the subalar graft in 2009 1 and 2013 2 described this technique as a way of correcting asymmetries of the nasal foundation, namely, the maxilla. They found that maxillary asymmetry, best seen on base view, correlated with nasal axis deviation, which is measured on the frontal view.…”

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confidence: 99%

The Utility of the Subalar Graft in Nostril Symmetry in Rhinoplasty

Lee

Luo

et al. 2021

Plastic &Amp; Reconstructive Surgery

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The Alignment of the Nose in Rhinoplasty: Fix Down Concept

Taş

2020

Plastic &Amp; Reconstructive Surgery

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Background: The current literature on rhinoplasty focuses mainly on the nasal profile (sagittal plane); however, the nose is a three-dimensional structure, and alignment of the nose in consideration of other aspects is important to achieve an aesthetic result. The author aimed to introduce the fix down concept, which includes fix down technique and the adjunct maneuvers for achieving alignment of the nose in three anatomical planes and improving the results of rhinoplasty in terms of symmetry. Methods: Between March of 2017 and December of 2017, a total of 102 patients (78 women and 24 men), 13 revision and 89 primary cases, underwent septorhinoplasty with the fix down concept. The noses were evaluated in coronal, sagittal, and axial planes and classified according to their deformities. Results: The functional and aesthetic results were satisfactory for the patients, examiners, and surgeon. No revisions were necessary during the follow-up period. In addition to the fix down technique, ethmoid bone grafting (16 patients), fix up technique (eight patients), dissection of the levator labii superioris alaeque nasi muscle (14 patients), plication of this muscle (four patients), superior-based transposition flap (39 patients), rim grafts (17 patients), mucosa grafts (12 patients), double-layer grafts (nine patients), maxillary deepening (five patients), maxillary augmentation with cartilage/bone grafts (21 patients), and supratip onlay grafts (seven patients) were used as adjunctive maneuvers to achieve symmetry in the frontal, base, and profile views. Conclusion: The presented fix down concept will help to provide three-dimensional symmetric noses for rhinosurgeons. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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The Subalar Graft and Its Role in Nasal Tip Medialization and Improved Nostril Symmetry

Cited by 2 publications

References 7 publications

The Utility of the Subalar Graft in Nostril Symmetry in Rhinoplasty

The Utility of the Subalar Graft in Nostril Symmetry in Rhinoplasty

The Alignment of the Nose in Rhinoplasty: Fix Down Concept

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