Reconstruction of the nasal alar.

The authors of this study describe a case of nasal alar deformity with a congenital deficiency of cartilage treated with a rotation flap. To choose the reconstruction technique, reference parameters such as the age of the patient, the presence of preexisting scars, and the size of the defect are assessed by focusing on the tissue structure and on the major aesthetic demands of the younger patients. Good aesthetic results, with an acceptable cicatricial outcome and an excellent morphofunctional reconstruction of the ala, were achieved in the treated subject. The postoperative course was also good with no complications.

Reconstruction of the nasal valve.

The authors present their experience with reconstructive nasal valve surgery, evaluating the effects related to the use of a composite graft, which is a graft made of skin and cartilage, or mucosa and cartilage, and to the transposition of mucocartilaginous flaps. A sample of 15 patients (12 women and three men) selected among 452 cases treated with functional and aesthetic rhinoplasty at the Department of Plastic and Reconstructive Surgery of the "Tor Vergata" University of Rome was analyzed. Patients were between 25 and 50 years of age, with a mean age of 40 years, and were treated with secondary rhinoplasty for valvular stenosis. Of these patients, 12 had functional problems of the internal and external nasal valve, and three had internal valve stenosis. In our sample of 15 patients, respiratory symptoms improved at short- and long-term follow up. In all cases, a good aesthetic result was obtained. The patients were not satisfied with the aesthetic result in only three cases as a result of enlargement or asymmetry of the external valvular area. In 11 cases, an "open tip" rhinoplasty was performed with a retroauricular skin-cartilage composite graft to correct internal-external valvular stenosis. In all the cases of internal valvular stenosis (three patients) and in one case of internal-external valvular stenosis, a transposition of mucocartilaginous flaps with a section of the mucosa of the upper lateral cartilage was performed.