Nasal Base Retraction: A Treatment Algorithm

Correction of Alar Base Retraction by Levator Labii Alaeque Nasi Muscle Dissection and Alar Rim Grafting: A Clinical Prospective Study

Alar base retraction may result in disharmony of nose structures. Although correction of this retraction may play an important role in patient satisfaction, there is a limited number of studies on alar base retraction correction. The aim of this study was to manage alar base retraction with minimal undesirable results. Six patients underwent correction of alar base retraction using dissection of the levator labii alaque nasi muscle with or sometimes without alar rim grafting. Assessment of the defect was done using preoperative and postoperative frontal view photographs of each patient. Comparing the preoperative and postoperative photographs shows a significant improvement in the nasal base asymmetry, and all six patients have aesthetically satisfying results after a 12-month follow-up period. In conclusion, nasal base retraction is a well-known deformity that has been an area of focus in the rhinoplasty field and management of this defect has very promising results.

Surgical Algorithms in Rhinoplasty: A Scoping Review of the Current Status

BACKGROUND

Algorithms define a sequence to approaching a subject. This study represents a scoping review seeking to define the role of surgical algorithms in rhinoplasty.

METHODS

A scoping review was conducted. Pubmed/MEDLINE, Web of Science, and Google Scholar, as well as a citation searching was performed to find eligible studies for review. Eligibility criteria included studies published in English, human subjects ≥ 15 years old, and all included surgical algorithms were for primary cosmetic rhinoplasty.

RESULTS

In total, 514 studies included the key search terms. Thirty-nine studies were evaluated for data extraction. The majority of the algorithms were from USA-based publications (22/39). Flow-chart type algorithm was used in 23 and text-based algorithms in 15 of the 39 studies. Algorithms related to tip shape and/or position were most frequent (19/39), followed by those for crooked nose and dorsal height. Only 7 of the algorithms described outcomes for utilizing the algorithm.

CONCLUSIONS

Very few surgical algorithms have been published for cosmetic rhinoplasty. A minority of these studies have published outcomes. This study provides a description and summary of these algorithms and also shows that future studies could be done to further develop surgical algorithms for rhinoplasty and evaluate outcomes.

LEVEL OF EVIDENCE III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com.