Abstract

Alar rim deformity is one of the most challenging problems to correct in nasal surgery. It is difficult to correct, recurs easily, and needs delicate handling. The technique to correct a hanging alar includes excision a vestibular skin, direct skin excision, and/or excision of the lateral crus. The technique to correct the minimal-to-mild alar retraction includes scar contracture release, alar rim grafts, V-Y advancement flap and composite grafts. In case of severely retracted alar, several techniques such as lateral crural strut graft, alar spreader graft, inter-cartilaginous graft, and island pedicled advancement flap of the nasal dorsum can help to correct the deformities. Alar rotation flap, septal extension graft, alar base surgery, and derotation graft also have some benefit.

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