Alar rim grafts didn't improve the triangular shape of my nostril. How can this problem be fixed? (Photo)

Question

Because of the triangular / notched shape of my left nostril I had revision rhinoplasty which involved the placement of alar rim grafts. Unfortunately this couldn't improve the shape of the nostrils. It seems as if it has no effect at all. The attached picture shows my nose before the revision, but as I mentioned there is no difference in the nostril shape. How can that problem be fixed? Are composite graft required instead? Thanks for your answers!

Michael T. Somenek, MD · Answer

It is difficult to see from the photo that you submitted how extensive the alar notching is. Alar notching can occur as a result of scar contracture or over resecting the cartilaginous structures that create support to the nasal tip and sidewall. To address this, composite grafts(a graft comprising both skin and cartilage frequently harvested from the ear) are a very good solution as it not only replaces structure, but also replaces the tissue deficit to help bring the rim of the nostril down further to a more pleasing anatomic position. Alar rim graft are more frequently used to create structure to a collapsing nostril from lack of support.

David Reinstadler, MD · Answer

The photo is small, but I think I understand what you are talking about. A retracted alar rim can result from over resection of the tip cartilages in initial surgery, or it can result just from wound healing and contraction of the soft tissue. Alar rim grafts are usually helpful at giving a collapsed rim some support, but usually doesn't bring the rim physically down to resolve the notching. Depending on other changes desired, there are a few options. If all you want is to lower the retracted ala, composite grafts are usually a great option. If you are retracted bilaterally on both profile views and were undergoing other changes to your nose, different options exist. I would see a revision rhinoplasty surgeon in person so they can examine your nose and discuss all the options. Best of luck

Alar rim grafts didn't improve the triangular shape of my nostril. How can this problem be fixed? (Photo)

Answers (2)

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Everything you need to know about Revision Rhinoplasty

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Alar rim grafts didn't improve the triangular shape of my nostril. How can this problem be fixed? (Photo)

Answers (2)

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Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.