The concept of narrowing the nasal alar base is external wedge excision technique in correction of the excess alar flare while hiding the incision in the alar-facial groove. Weir first described the alar base resection in 1892. In 1931, Joseph and Milstein described narrowing the nostril base and vestibular floor. In 2007, Foda described the combined alar base excision technique for nasal base narrowing in cases of a wide alar base with excessive nasal flare. The alar base plays an important role in the overall appearance and balance of the nose. The alar base, however, is not often evaluated independently during nasal examinations at the time of surgery. As a result, it is one of the most frequently encountered imperfections during secondary rhinoplasty. Deformities of the nasal alar base are a common finding in secondary rhinoplasty. Although some are recognized easily, many deformities are subtle and will be identified only during a detailed examination by the surgeon. A primary deformity that does not occur at the beginning or develops as a secondary deformity, for example, excessive flaring, may develop after reconstruction of the tip projection. When narrowing the alar base, a limited resection is preferred to a comprehensive, since resecting additional alar tissue is simple while having to reconstruct a stenotic alar is a complicated process. In this chapter, alar base surgery is discussed in all aspects.
Alar base Surgery Rhinoplasty Deformity Narrowing
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Weir RF. On restoring noses without scarring the face. N Y Med J. 1892;56:449–54.Google Scholar
Joseph J. Nasenplastik und sostige Gesichtsplastik nebst einem Anhang über Mamaplastik. Leipzig: Curt Koitzsch; 1931. p. 110–3.Google Scholar
Foda HMT. Nasal base narrowing: the combined alar base excision technique. Arch Facial Plast Surg. 2007;9:30–4.CrossRefGoogle Scholar
Becker DG, Weinberger MS, Greene BA, Tardy ME. Clinical study of alar anatomy and surgery of the alar base. Arch Otolaryngol-Head Neck Surg. 1997;123:789–95.CrossRefGoogle Scholar
Constantian MB. An alternate strategy for reducing the large nasal base. Plast Reconstr Surg. 1989;83:41–52.CrossRefGoogle Scholar
Jackson IT, Moos KF, Sharpe DT. Total surgical management of Binder’s syndrome. Ann Plast Surg. 1981;7:25–34.CrossRefGoogle Scholar
Santana PSM. Treatment of the Negroid nose without nasal alar excision: a personal technique. Ann Plast Surg. 1991;27:498–506.CrossRefGoogle Scholar
Tebbetts JB. Primary rhinoplasty: a new approach to the logic and the techniques. St. Louis, MO: Mosby; 1998.Google Scholar
Warner JP, Chauhan N, Adamson PA. Alar soft tissue techniques in rhinoplasty: algorithmic approach, quantifiable guidelines, and scar outcomes from a single surgeon experience. Arch Facial Plast Surg. 2010;12(3):149–58.CrossRefGoogle Scholar
Kridel RW, Castellano RD. A simplified approach to alar base reduction: a review of 124 patients over 20 years. Arch Facial Plast Surg. 2005;7(2):81–93.CrossRefGoogle Scholar