Nasal Base Reduction: A Treatment Algorithm Including Alar Release with Medialization

Abstract

Not all causes of a broad nasal base are amenable to resection procedures, especially the generally broad nasal base such as that due to thick skin or a vertically oriented alar axis. However, a tension-free alar release with medialization by suture fixation is effective. The incidence of recurrence can be expected to be reduced.

Preservation of nostril morphology in nasal base reduction

“…Internal methods are effective [5,9], but are often complicated by a scar oriented perpendicular to the nostril sill, which may sometimes cause prominent notching [5]. Although many surgeons use external cutaneous excision to avoid the risk of notching of the alar rims, this may result in a decrease in alar flare with no true decrease in the width of the alar base [8].…”

“…Based on techniques pioneered by Kridel and Castellano (wedge and sill excision) [5] and Gruber et al (more lateral alar reduction with cinching sutures along the sill/columella) [9], we sought to minimize the risk of nostril notching by combining techniques of raising triangular flaps and using cinching sutures to avoid any tension on the tissues.…”

Nasal Base Narrowing of the Caucasian Nose Through the Cerclage Technique

“…In patients with thin skin and subcutaneous tissue scarce, as in the Caucasian nose, the results are more expressive. In patients with very thick skin and excess subcutaneous tissue, the suture can become less effective and should be performed to decrease the inter-alar distance by other means (2,3,6).…”

“…Several papers mention different techniques to narrow the nasal base in the mestizo nose and african descent, (1-8) to mention but a few Caucasian nose. The enlargement of the nasal base after the surgery reductional the Caucasian nose and the permanence of the inter-alar distance greater than the inter-canthal distance (Figure 2), can be harmonized with the resection of the ellipse of skin and lip narinário posterior technique suture cerclage (3).…”

Correcting the Alar Base Retraction in Crooked Nose by Dissection of Levator Alaque Nasi Muscle

“…1 However, these excisional procedures may result to nostril distortion or stenosis, and these techniques will effect the width of the nasal base. 1,2 The question is whether the width of the nasal base is normal.…”