14th World Congress of Asia Pacific Academy of Cosmetic Surgery (APACS)マニラ、フィリピン 2013/10/26-27

How I perform my alar lift for Rhinoplasty

Keizo Fukuta, M.D
Verite clinic, Tokyo JAPAN
ginza@veriteclinic.com

The columella retrusion is a source of poor relationship between columella and alar base. Another cause is low set alar.

I used to apply two different procedures to correct low set alar.

The first one was suture suspension of the dermis of alar base to the nasal dorsum.

Another procedure I used was excision of vestibular skin near the alar base at 2mm cephalic to the nostril rim; this method was previously presented by Dr. Yap.

It was found that both procedures made subtle effect of lifting the alar base. The suture suspension showed a risk of infection and relapse in one year.

The demerit of vestibular excision was thickening of alar lobule due to inverting the tissue of alar rim.

This paper presents my new approach for lifting the alar base.

The full thickness incision is made along the alar groove, detaching the alar lobule from the cheek.

The alar tissue is excised at the superior margin of the alar lobule.

The alar was repositioned superiorly. The skin defect at the bottom on the cheek surface is closed with V-Y advancement.

This technique can reposition the alar superiorly and also reduce the size of alar lobule particularly in a vertical dimension.

The scars which develop in the superior margin of the alar lobule and below the alar base are tolerated by the patients.

Another potential side effect is widening of the nostril floor.

The presentation shows the surgical technique in video and demonstrates clinical results.

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