Lin Yen-Pin, Kwon Soo Ha, Chen Peter Ruei-Feng, Yen Cheng-I
Vendôme Aesthetic Medical Center, 4F, No.149, Sec 3, Xinyi Rd., Da'an Dist., Taipei City, Taiwan.
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Taoyuan, Taiwan.
Aesthetic Plast Surg. 2025 Mar 31. doi: 10.1007/s00266-025-04803-1.
Hanging alae is a common aesthetic problem in Southeast Asian noses. The alar overhang gives a poor aesthetic relation between the alar and columellar base described as a "heavy hypertrophic alar" appearance. Alar lift surgery is an integral part of any rhinoplasty procedure, but is often overlooked by surgeons performing rhinoplasty. Unnatural looking scar caused by skin graft or anatomic junction disruption is often found after alar base lift surgery. Hiding the incision along the nasolabial fold with a rotation flap can reduce the tension during wound healing, decrease length discrepancy caused by vertical reduction, and close the defect after vertical lift of the alar component.
After vertical reduction and lift of the lateral part of the ala, the basal defect is repaired with a small rotation flap along the nasolabial fold; the alar base rotation flap (ABRF). All the patient received alar base lift with an ABRF, and received 2D photometric evaluation before and after surgery.
No tip circulation compromise was noted. All patient healed well with a barely noticeable scar, and an improved alar-columellar relationship (ACR). The vertical alar base distance index decreased 3.38% (p < 0.005), and alar columellar angle decreased 15.8° (p < 0.005).
Alar base lift with ABRF improves the ACR, and provides an elevated alar base position with a less visible scar.
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鼻翼下垂是东南亚人鼻子常见的美学问题。鼻翼悬垂导致鼻翼与鼻小柱基部之间的美学关系不佳，呈现出“肥厚性鼻翼沉重”的外观。鼻翼提升手术是任何鼻整形手术不可或缺的一部分，但常被鼻整形外科医生忽视。鼻翼基部提升手术后，常可见皮肤移植或解剖结构破坏导致的不自然瘢痕。采用旋转皮瓣沿鼻唇沟隐藏切口，可减少伤口愈合时的张力，减少垂直缩短引起的长度差异，并在鼻翼部分垂直提升后闭合缺损。
在垂直缩短并提升鼻翼外侧部分后，沿鼻唇沟用小旋转皮瓣修复基部缺损；即鼻翼基部旋转皮瓣（ABRF）。所有患者均采用ABRF进行鼻翼基部提升，并在手术前后接受二维光度评估。
未发现鼻尖血运受损。所有患者愈合良好，瘢痕几乎不明显，鼻翼与鼻小柱的关系（ACR）得到改善。鼻翼基部垂直距离指数下降3.38%（p<0.005），鼻翼与鼻小柱夹角下降15.8°（p<0.005）。
采用ABRF进行鼻翼基部提升可改善ACR，并使鼻翼基部位置升高，瘢痕更不明显。
证据等级IV：本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述，请参阅目录或作者在线指南www.springer.com/00266。
