Effects of a special shaped tip cartilage support structure on alar rim retraction / 中华医学美学美容杂志

ABSTRACT

Objective:To investigate the clinical effectiveness and significance of special fixing cartilaginous support structure on nasal tip to prevent and correct alar rim retraction.Methods:Special shaped tip extension support structure was composed of two parts of type Ⅲ of septum extension graft (SEG) and two pieces of wedge graft fixed on either side of the cephalic end near the top of support structure. After the alar cartilage vault was fixed to the nasal tip cartilage support structure, the lower lateral cartilage (LLC) cephalic was fixed to both sides of this nasal tip support structure. The LLC received support from the cartilaginous support structure to counter and correct the lower lateral cartilage cephalic retraction. From January 2017 to January 2020, this surgical procedure was used in 34 patients (aged from 20 to 46 years, with mean 32.6 years) with rhinoplasty who had a nasal tip support structure but still had a space between the LLC and the stent intraoperativly. Preoperativly, 4 cases had normal relation of alar columella and alar rim, 18 cases had mild alar rim retraction, and 12 cases had moderate alar rim retraction. The patients were followed up for 6 to 18 months to observe the correction effect and patient satisfaction.Results:Among the 34 patients, 8 patients received alar edge graft, 2 patients received lateral foot support graft, and 2 patients received alar rim graft combined with lateral foot support graft. All patients were followed up for 6-18 months, 30 patients with alar rim retraction were completely corrected, and 4 patients with normal alar and nasal columella relationship did not have alar rim retraction after surgery. No complications such as infection, necrosis, contracture or respiratory dysfunction were found in all patients. 28 cases (82.4%) were very satisfied; 6 cases (17.6%) were satisfied; the satisfactory rate was 100%.Conclusions:The special shaped nasal tip cartilage support structure combined with type Ⅲ SEG and its cephalic wedge grafts could achieve satisfactory clinical results in the prevention and correction of alar rim retraction.