Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Plastic Surgery, the Central Hospital of Wuhan, Tong ji Medical college, Huazhong University of Science and Technology, Wuhan, China.
J Craniofac Surg. 2023 Oct 1;34(7):2168-2172. doi: 10.1097/SCS.0000000000009435. Epub 2023 May 29.
Current strategies for correcting alar retraction mainly include cartilage grafting and composite grafting, which are relatively complicated and may produce injury to the donor site. Herein, we introduce a simple and effective external Z-plasty technique for correcting alar retraction in Asian patients with poor skin malleability.
Twenty-three patients were presented with alar retraction and poor skin malleability, and they were very concerned about the shape of the nose. These patients undergoing external Z-plasty surgery were analyzed retrospectively. In this surgery, no grafts were needed, and the location of the Z-plasty was according to the highest point of the retracted alar rim. We reviewed the clinical medical notes and photographs. During the postoperative follow-up period, patients' reported satisfaction with aesthetic outcome were also evaluated.
The alar retraction of all the patients was successfully corrected. The postoperative mean follow-up period was 8 months (range: 5-28 mo). No incidents of flap loss, recurrence of alar retraction, or nasal obstruction were observed during postoperative follow-up. Within postoperative 3-8 weeks, minor red scarring was visible at the operative incisions in most patients. However, these scars turned unobvious after postoperative 6 months. There were 15 cases (15/23) being very satisfied with the aesthetic outcome of this procedure. Seven patients (7/23) were satisfied with the effect and the invisible scar of this operation. Only one patient was dissatisfied with the scar, but she was satisfied with the correction effect of the retraction.
This external Z-plasty technique can be an alternative method for correction of alar retraction with no need of cartilage grafting, and the scar can be unobvious with fine surgical suture. However, the indications should be limited in patients with severe alar retraction and poor skin malleability, who should not particularly care about the scars.
目前矫正鼻翼退缩的策略主要包括软骨移植和复合移植，这些方法相对复杂，并且可能对供区造成损伤。在此，我们介绍一种简单有效的外部 Z 成形术技术，用于矫正亚洲患者鼻翼退缩和较差的皮肤延展性。
23 例鼻翼退缩伴皮肤延展性差且对鼻部外形非常关注的患者接受了外部 Z 成形术，对这些患者进行了回顾性分析。在该手术中，不需要移植，Z 成形术的位置根据退缩的鼻翼边缘的最高点确定。我们回顾了临床病历和照片。在术后随访期间，还评估了患者对美学效果的满意度。
所有患者的鼻翼退缩均得到成功矫正。术后平均随访时间为 8 个月（范围：5-28 个月）。在术后随访期间，未观察到皮瓣丢失、鼻翼退缩复发或鼻阻塞。在术后 3-8 周内，大多数患者手术切口可见轻微红色瘢痕，但术后 6 个月后瘢痕变得不明显。有 15 例（15/23）对该手术的美学效果非常满意，7 例（7/23）对该手术的效果和不可见的瘢痕满意。只有 1 例患者对瘢痕不满意，但对退缩的矫正效果满意。
这种外部 Z 成形术技术可以作为一种替代方法，用于矫正鼻翼退缩，无需软骨移植，且瘢痕不明显，手术缝线精细。但是，该方法的适应证应局限于严重鼻翼退缩和较差皮肤延展性的患者，且这些患者不应特别关注瘢痕。
