The “Sail” Excision Technique: A Modified Alar Lift Procedure for Southeast Asian Noses

Abstract

Objective: To describe a new “sail” shaped excision technique for alar lift surgery and present the outcome of this technique through photo documentation.
 Methods:
 Study Design: Surgical Innovation; Case series
 Setting: Tertiary Government Hospital
 Participants: Four patients underwent alar rim lift procedure using “sail” excision technique performed by the senior co-author. The indication for “sail” excision technique was a hanging ala (type IV) based on the classification of alar-columellar discrepancies by Gunter et al. The outcomes were described with comparison of pre-operative and post-operative photographs.
 Results: Post-operative improvement of the alar-columellar relationship and counter-rotation of the tip, the “gull’s wing in flight” was further enhanced. There were no scar contracture or vestibular stenosis, and scars were aesthetically acceptable.
 Conclusion: Alar lift surgery demands an accurate diagnosis and analysis of the alar-columellar discrepancies. In Southeast Asian noses, unlike Caucasian noses, the most common indication for alar surgery are wide and overhanging ala. Our proposed technique is an easy and safe method of correcting alar overhang. This procedure with its advantages represents a new, reliable and simple way of achieving predictable results in many rhinoplasty cases.
 Keywords: alar lift, hanging ala, alar-columellar relationship, alar-columellar discrepancies, counter-rotation of tip, vestibular stenosis