Other Options for Fixing Alar Rim Retraction After Cartilage Graft Failed to Solve Problem? (photo)

I have severe alar rim retracting on my left nostril caused by scarring inside of the nostril. I already had a revision in which a graft composed of ear cartilage was placed on the alar rim to try to bring down the nostril. This however did not work. In fact, it made the retraction worst. What are my options? I really need this fix. Also, I have no more ear cartilage left to harvest. It was previously used up revising a botched rhinoplasty.

Doctor Answers (5)

Alar rim retraction

+2

Dr Fleming's comment is correct, but one alternative is to do nothing. Your retraction, based on the submitted photos, is not that noticeable. And remember that each surgery has risks, however small.


Sacramento Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Other Options for Fixing Alar Rim Retraction After Cartilage Graft Failed to Solve Problem?

+1

     The retraction is really not that severe.  Scar formation after surgery can create a tethering effect after primary rhinoplasty and in alar graft revision.  You could do a composite graft, which would lead to possible additional asymmetry.  You could also consider filler to this area to infuse the area of scar with a little more volume that can produce a nice long term effect even with a temporary filler.  All of these have pros and cons, and you will have to decide what makes the most sense for you.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 218 reviews

Alar retraction

+1

Your retraction based solely on the photos does not look bad. However, a composite graft of ear cartilage and ear skin is usually the best method of treatment.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

You might also like...

Persistent Alar Rim Retraction

+1

For cases such as yours the clear choice would be to use a mini-composite graft which is composed of both cartilage and skin. These grafts are harvested from the Cymba concha in the ear (a different place from where cartilage is typically harvested) and do extremely well. The operation can be done under local anesthesia using a closed technique and does not require any dressing or tape on the nose postoperatively.  

Andrew S. Frankel, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Correction of Alar Rim Retraction

+1

If previous placement of a cartilage graft did not correct your alar rim retraction you probably need a composite graft which includes both skin and cartilage. In 35 years I've never seen a patient that did not have enough skin and cartilage to correct a retraction like yours.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.