Abstract
BackgroundAlar cartilage can be very useful for tip and dorsum grafts. Depending on its size and thickness, it can be an important alternative for spreader grafts to improve endonasal functional deficiencies, correct deviated noses, and prevent inverted “V” deformities. Caucasian patients with bulbous tips are the most common candidates to achieve such benefits. It is easy to obtain and to frame into a desired graft.MethodsThe authors describe a surgical technique using the alar cartilages as spreader grafts. All Caucasian patients with bulbous tips who underwent primary rhinoplasty were included. All patients have been evaluated after 3 to 4 months and after 1 and 2 years by aesthetical and functional criteria.ResultsThirty-four patients (28 female and 6 male) underwent this procedure between 2001 and 2015: 94% reported a better airflow, 91% reported very good aesthetic results and were very satisfied 2 years postoperatively, and 12% had nasal deviations that were corrected with a one side double-layered spreader grafts. Two patients presented supra-tip deformities and one patient had a columella scar that was revised surgically. No cases of inverted “V” deformity were reported 2 years postoperatively.ConclusionsPatients with functional satisfaction and with a straight and smooth dorsum seem to be the most important benefits that were achieved with this technique using alar cartilage spreader grafts, an alternative that can be offered to improve airflow and to prevent deviated and inverted “V” deformities.Level of Evidence: IV, therapeutic study.
Highlights
Rhinoplasty techniques date back to the nineteenth century, as first described by Roe [1]
Patients with pronounced and bulbous nasal tips were selected as good candidates to improve airflow and to prevent an inverted V deformity, from 2001 to 2015 in our Division of Plastic Surgery using alar cartilages as spreader grafts
We have considered patients with alar cartilages from 19 to 26 mm length, 9 to 12 mm width, and 2.5 to 3.5 mm thickness (Fig. 1)
Summary
Rhinoplasty techniques date back to the nineteenth century, as first described by Roe [1]. One of the greatest challenges in rhinoplasty is maintaining endonasal integrity and functional nasal vault activity [5, 6]. The endonasal vaults are the narrowest part of the airway. These structures are defined by the junction between the septum and the caudal superior lateral cartilages, forming an angle of 10–15° in Caucasians (leptorrhine) and a larger angle in people of African and Asian heritage (platyrrhine) [5, 7, 8]. Alar cartilage can be very useful for tip and dorsum grafts. It is easy to obtain and to frame into a desired graft
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