Are Alar Batten Grafts the solution for the indentation on both sides of my nose tip for a revision? (photos)

Question

Are Alar Batten Grafts a good choice to raise the sides of my nose tip where it appears to be an indentation? I have external nasal valve collapse upon deep inspiration specially when nose cycle happens. Would this be a revision Rhinoplasty ? Are Alar Batten Grafts a good solution?

Nima Shemirani, MD · Answer

Dear Camilo,You are correct, cartilage grafts are used to camoflauge and fix those indentationsBatten grafts are typically placed under the your native cartilages, and you would have a variation of thatWhen you are ready, seek out a revision rhinoplasty surgeon who regularly performs revision rhinoplasty because it can be complexBest,
Dr. Nima
Member, American Academy of Facial Plastic and Reconstructive Surgery
Board Certified Facial Plastic Surgeon
Board Certified in Head and Neck Surgery

Scott Trimas, MD · Answer

Without any other additional information, it may be that alar battens would improve your symptoms of nasal obstruction upon inspiration as well as correct the indentions near the sides of the tip region. That being said you still need a thorough examination by a facial plastic surgeon in your area to check your entire nose out including the septum that can contribute to breathing issues. If you had a previous rhinoplasty, then you may very well be right that alar battens are needed. Keep in mind that alar battens might widen your nose some if it is indeed required. Good luck in your area.

Eric M. Joseph, MD · Answer

If you didn't have a functional issue with your nose, permanent nonsurgical rhinoplastic treatments may be helpful for deep supra-alar creases, but this would not provide functional benefit. Batten grafts, or lateral crural extension grafts may extend from the indentations onto the bones of your cheeks. Consider consulting with several rhinoplasty specialists so you could see what might be best for you moving forward. Thank you. Dr Joseph

Roberto E. Garcia, MD, FACS · Answer

Thank you for your question about alar batten grafts.  Yes, they are a very useful tool in the Rhinoplasty surgeons armamentarium.  These grafts are utilized for various reasons including stabilizing the lower lateral cartilages, extending the alar rim, and making concave cartilages into convex cartilages to aid in external valve collapse.  Revision rhinoplasty is a very complicated procedure that should really only be done by specialists in the face and nose.  Please make sure that you are seeking the advice of a double board certified Facial Plastic Surgeon.  IF your surgeon does anything other than faces, they are not specialists.

William Portuese, MD · Answer

A full set of facial photographs, and an in-person examination, and copies of the operative report are going to be required to make a determination about which techniques to use in revision rhinoplasty. With the revision rhinoplasty, there has been previous alterations to the normal anatomy, and scar tissue formation. Revision rhinoplasty is much more difficult  than a primary rhinoplasty, so the techniques performed are best determined at the time of the consultation. Choose your second surgeon wisely based on extensive experience.

Michael Elam, MD (retired) · Answer

Dear Camilo, During consultations you will need to have an intra-nasal examination to determine a proper diagnosis regarding your breathing difficulties. Your valve collapse can be caused from taking out to much lateral crus which will also cause the indentations that you are concerned about.  Once a diagnosis is provided then the surgeon can discuss the techniques which will be used to improve your breathing and aesthetics. Best regards, Michael V. Elam, M.D.

Daniel Greenwald, MD (in memoriam) · Answer

It is possible that cartilage grafts can fill in these defects.  Be sure to consult a surgeon certified by the American Board of Plastic Surgery who has enough experience to be able to show you a comprehensive portfolio of pre- and post-op photos.

Are Alar Batten Grafts the solution for the indentation on both sides of my nose tip for a revision? (photos)

Answers (7)

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