Significant lowering of alar rim with cartilage repositioning

(HealthDay)—Patients who undergo lateral crural repositioning have significant lowering of the alar rim, according to a study published online Nov. 19 in JAMA Facial Plastic Surgery.

Christian A. Paquet, M.D., from the University of Southern California in Los Angeles, and colleagues retrospectively reviewed data from 54 patients (102 hemi-noses; 79 percent women) who had lateral crural repositioning performed by the same surgeon. Patients were included if they had standardized photographs taken preoperatively and at least six months postoperatively (average time, 11.3 months).

Eighty-three percent of the cases were revision rhinoplasties. The researchers found that there was a net decrease of 6.8 degrees based on the preoperative and postoperative mean anterior nostril apex angles (P < 0.001). A similar result was seen comparing preoperative and postoperative angles on exclusion of patients who had other rim-lowering grafts, with a net decrease of 6.6 degrees (P < 0.001). Decreases of 6.9 and 6.7 degrees, respectively, were seen when examining patients who underwent lateral crural repositioning alone and those who also had lateral crural strut grafts (both P < 0.001).

"The results demonstrate that repositioning of the lower lateral cartilages with or without a lateral crural strut graft into a more caudal pocket results in a statistically significant lowering of the alar rim," the authors write.