Alar Lifting Technique for the Correction of Tilted Alar Base

Abstract

Background Frequently, a tilted alar base characterized by a discrepant level of the nostril sill and alar insertion on both sides is encountered in patients seeking rhinoplasty. Herein, we report our surgical technique and outcome of alar lifting technique for correcting tilted alar base. Methods The medical records of 18 patients with alar base asymmetry who underwent rhinoplasty using the alar lift technique between January 2014 and December 2019 were retrospectively reviewed. The alar lifting procedure included a pointed ellipse-shaped excision of vestibular skin just inside the nostril sill, and sutures using 5-0 monocryl. Surgical outcomes were determined on the frontal view of facial images by comparing pre- and postoperative angles formed by a line drawn parallel to the lowermost part of both pupils and a line connecting the lowermost part of the base of the ala. Results Of 18 patients, 12 (66.7%) were men, and 6 (33.3%) were women. The mean age was 31.8 years (range 16-55). The alar lifting technique was performed on the left side in 12 cases and on the right side in 6 cases, and concurrent tip plasty was performed in 15 (83.3%) cases. The mean alar tilt angle was 3.9 preoperatively and 2.0 postoperatively. The mean angle change was 1.9 degrees. Sixteen (88.9%) out of 18 patients had decreased alar level discrepancy. No patient had complications. Conclusions Our alar lifting technique can serve as a useful adjunctive technique in rhinoplasty in patients with a tilted ala.