Jang Yong Jun, Kim Sung Min, Lew Dae Hyun, Song Seung Yong
Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea.
Imi Plastic and Aesthetic Surgery Clinic, Seoul, Korea.
Arch Plast Surg. 2016 Nov;43(6):564-569. doi: 10.5999/aps.2016.43.6.564. Epub 2016 Nov 18.
Alar retraction is a challenging condition in rhinoplasty marked by exaggerated nostril exposure and awkwardness. Although various methods for correcting alar retraction have been introduced, none is without drawbacks. Herein, we report a simple procedure that is both effective and safe for correcting alar retraction using only conchal cartilage grafting.
Between August 2007 and August 2009, 18 patients underwent conchal cartilage extension grafting to correct alar retraction. Conchal cartilage extension grafts were fixed to the caudal margins of the lateral crura and covered with vestibular skin advancement flaps. Preoperative and postoperative photographs were reviewed and analyzed. Patient satisfaction was surveyed and categorized into 4 groups (very satisfied, satisfied, moderate, or unsatisfied).
According to the survey, 8 patients were very satisfied, 9 were satisfied, and 1 considered the outcome moderate, resulting in satisfaction for most patients. The average distance from the alar rim to the long axis of the nostril was reduced by 1.4 mm (3.6 to 2.2 mm). There were no complications, except in 2 cases with palpable cartilage step-off that resolved without any aesthetic problems.
Conchal cartilage alar extension graft is a simple, effective method of correcting alar retraction that can be combined with aesthetic rhinoplasty conveniently, utilizing conchal cartilage, which is the most similar cartilage to alar cartilage, and requiring a lesser volume of cartilage harvest compared to previously devised methods. However, the current procedure lacks efficacy for severe alar retraction and a longer follow-up period may be required to substantiate the enduring efficacy of the current procedure.
鼻翼退缩是鼻整形术中一种具有挑战性的情况，其特征为鼻孔暴露过度和外观不佳。尽管已经介绍了各种矫正鼻翼退缩的方法，但每种方法都有缺点。在此，我们报告一种仅使用耳甲软骨移植来矫正鼻翼退缩的简单手术方法，该方法既有效又安全。
2007年8月至2009年8月期间，18例患者接受了耳甲软骨延伸移植以矫正鼻翼退缩。耳甲软骨延伸移植片固定于外侧脚的尾缘，并覆盖前庭皮肤推进皮瓣。对术前和术后照片进行回顾和分析。对患者满意度进行调查并分为4组（非常满意、满意、一般或不满意）。
根据调查，8例患者非常满意，9例满意，1例认为结果一般，大多数患者对结果满意。鼻翼缘至鼻孔长轴的平均距离减少了1.4毫米（从3.6毫米降至2.2毫米）。除2例出现可触及的软骨台阶样改变但未出现任何美学问题外，无其他并发症发生。
耳甲软骨鼻翼延伸移植是一种矫正鼻翼退缩的简单、有效方法，可方便地与美容鼻整形术相结合，利用与鼻翼软骨最相似的耳甲软骨，与先前设计的方法相比，所需采集的软骨量较少。然而，目前的手术方法对严重鼻翼退缩缺乏疗效，可能需要更长的随访期来证实该方法的持久疗效。
