Evaluation of Scar Outcome After Alar Base Reduction Using Different Surgical Approaches

Hudise, Jibril Y.; Aldhabaan, Saud A.; Nassar, Raad S.; Alarfaj, Ahmed

doi:10.1016/j.joms.2020.06.021

Cited by 13 publications

(25 citation statements)

References 9 publications

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“…7,9 The SBSES included evaluating the scar discoloration, width, possible notching, and depression or elevation to the neighboring skin. 7,9 Each item was classified as present (0) or absent (1). In total, 5 items were included.…”

Section: Outcome Measurementsmentioning

confidence: 99%

Correcting Wide Alar Base and Flare With Combined Sill and Alar Excision in Asian Patients

Chen

et al. 2021

Journal of Craniofacial Surgery

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Background: Obvious scar and deformities are commonly observed with incision anterior to the alar-facial groove in alar excision surgery. The authors explored modified sill and alar excision to correct wide alar base and flare synchronously and decreased incident of unacceptable scar and deformities in Asian patients. Methods: The authors conducted a retrospective cohort study including 52 consecutive patients undergoing this surgery. Contrary to previous studies, the incision for alar excision was located in the alar-facial groove and was closed by intracutaneous suture. Scars were assessed with visual analog scale and the Stony Brook Scar Evaluation Scale. Ratio of the interalar distance to intercanthal distance, nostril shape, and nostril symmetry was recorded.Results: The mean follow-up time was 18 months. Visual analog scale results showed 50 patients (96.2%) reported unnoticeable scar and 2 noticeable but acceptable scar. Stony Brook Scar Evaluation Scale results indicated 49 patients (94.2%) with good scar outcomes and 3 (5.8%) with moderate scar outcomes. The mean ratio of interalar distance to intercanthal distance reduced significantly from preoperative 1.10 to postoperative 1.02. The frequency of horizon-shaped nostrils changed from preoperative 16 cases (30.8%) to postoperative 2 cases (3.8%). The frequency of the pear-shaped (preferred shape) nostrils improved from preoperative 15 cases (28.8%) to postoperative 26 cases (50.0%). The frequency of symmetrical nostril shape improved from preoperative 36 patients (69.2%) to 42 (80.8%). There were no patients with complications like alar deformities, and patients' dissatisfaction. Conclusions: When performing sill and alar excision in Asian patients, the authors recommended a modified approach with the incision for alar excision being placed in the alar-facial groove and closed by intracutaneous suture, which can avoid obvious scar and deformities in Asian patients.Level of evidence: Level 4.

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Section: Outcome Measurementsmentioning

confidence: 99%

Correcting Wide Alar Base and Flare With Combined Sill and Alar Excision in Asian Patients

Chen

et al. 2021

Journal of Craniofacial Surgery

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“…However, residual columellar incision scars or possible deformities due to scar formation are the main disadvantages of this technique. Scar formation is influenced by factors such as incision and closure method, as well as postoperative care (1)(2)(3)(4). Previous studies have shown that absorbable sutures can be used safely in the columella without any long-term cosmetic concerns or an increased infection risk (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Comparison of scar outcomes of alar base and columella using irradiated polyglactin 911: a single-blind study

Ceylan¹,

YÜCEL²

2023

Anatolian Current Medical Journal

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Aim: The formation of scars on the face after open septorhinoplasty (SRP) with alar base reduction may disturb the patient due to cosmetic concerns. This study aimed to compare scar outcomes of the columella and alar base in patients undergoing SRP. Material and Method: Twenty-seven patients who underwent alar base reduction during primary open SRP were divided into two groups according to the intervened area as the Columella (CLM) group (n=27) and the Alar Base (AB) group (n=27). Irradiated polyglactin 911 was used in all patients. The modified Stony Brook Scar Evaluation Scale (SBSES) and a questionnaire form were used to measure scar outcomes and patient satisfaction. Columellar and alar base scar outcomes were compared. Results: Patient satisfaction and scar outcomes were better in the CLM group. There was no significant difference, except for the first month total SBSES scores, between the CLM and AB groups. There was no significant difference in patient questionnaire scores between groups. In the early period, there were more signs of inflammation in the alar base than in the columella, without statistical significance. Conclusion: Patient satisfaction and scar outcomes in the columellar area were favorable. Scar outcome on the alar base was statistically significantly worse than columella in the early period. There was no statistically significant difference between both areas in the long-term. Irradiated rapid vicryl can be used for closure of the alar base and columella, considering its advantages and disadvantages, in patients undergoing open septorhinoplasty with alar base reduction.

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“…The concept of narrowing the alar base dates back to the early days of modern rhinoplasty when Robert Wier in 1892, described the use of external alar wedge excisions to correct the unattractive alar flare that follows rhinoplasty [4].…”

mentioning

confidence: 99%

“…Joseph and Milstein used internal excisions in 1931 from the nostril base and floor of the vestibule [4]. This concept was later modified and popularized by many authors, mainly to avoid the external scar that follows the classic Wier excision [5].…”

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confidence: 99%

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Modification of the Basal View after Internal Alar Reduction

Nasr

Raafat

Narsha

et al. 2020

The Egyptian Journal of Plastic and Reconstructive Surgery

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Evaluation of Scar Outcome After Alar Base Reduction Using Different Surgical Approaches

Cited by 13 publications

References 9 publications

Correcting Wide Alar Base and Flare With Combined Sill and Alar Excision in Asian Patients

Correcting Wide Alar Base and Flare With Combined Sill and Alar Excision in Asian Patients

Comparison of scar outcomes of alar base and columella using irradiated polyglactin 911: a single-blind study

Modification of the Basal View after Internal Alar Reduction

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