Nasal sill augmentation: an overlooked concept in rhinoplasty\u2014a technical note and review of the literatures

Gholamhossein Adham,Seied Omid Keyhan,Mohan Thomas,Hamid Reza Fallahi,Heliya Ziaei

doi:10.1186/s40902-021-00298-3

Abstract

BackgroundNasal sill is one of the components of the alar ring, affecting the esthetic outcomes of rhinoplasty; accordingly, we developed a novel technique to adjust defects in this area and compared it with the available techniques.MethodsOur technique was based on creating a tunnel access to the nasal sill area through an incision made in the lower third of the columella using the open approach or through a nostril base incision in patients, who underwent alar base reduction, followed by insertion of a cartilaginous graft into the marked defect area.ResultsA total number of 54 patients with a defect in the nasal sill area were included in this study. Thirty-one patients underwent open rhinoplasty with the sill approach from the lower third of the columella, while 23 patients underwent rhinoplasty with a nostril base approach for nasal sill augmentation procedure. There were no reports of patient dissatisfaction, infection, bleeding, sensory dysfunction, or remaining asymmetry of the sill area.ConclusionBased on the findings of the present study, this technique can be successfully used in reconstructing the nasal sill area with minimal complications and morbidity.

Highlights

Nasal sill is one of the components of the alar ring, affecting the esthetic outcomes of rhinoplasty; we developed a novel technique to adjust defects in this area and compared it with the available techniques
This study aims to introduce a novel technique for nasal sill augmentation and compare it with previous techniques briefly
The need for nasal sill grafting/augmentation may be considered by a surgeon during an esthetic surgical procedure on the nose

Summary

Introduction

Nasal sill is one of the components of the alar ring, affecting the esthetic outcomes of rhinoplasty; we developed a novel technique to adjust defects in this area and compared it with the available techniques. Attention to the anatomy of cartilages and bones in the nasal area, which plays an important role in the esthetics and/or function of the nose, can positively affect the outcomes of the rhinoplasty. A comprehensive understanding of the unique anatomy of nasal sills is very important, as it exerts prominent effects on the size and shape of nostrils, and more generally, on the esthetic outcomes of nasal procedures [3, 4]. With or without alar wedge excision, is a method for decreasing the amount of alar flare and changing the nostril size, shape, and angle as part of the rhinoplasty procedure [5]. Care must be provided during these procedures, as improper resection of the

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