AN ALAR BASE FLAP TO CORRECT NOSTRIL AND VESTIBULAR STENOSIS AND ALARBASE MALPOSITION IN RHINOPLASTY

Nostril and vestibular stenoses can be properly reconstructed by compo site grafts from the alar lobule or ear. However, when alar base malpo sition accompanies the nostril stenosis, composite grafting will enlar ge the nostril but not correct the alar base displacement. An alar bas e flap designed as a crescent adjacent to the alar base, elevated, and transposed on subcutaneous and musculocutaneous perforators corrects the nostril stenosis and repositions the alar base simultaneously. Ant erior, active rhinomanometry demonstrates a substantial increase in me an nasal airflow from this reconstructive maneuver alone. The author h as used the flap successfully in 29 secondary rhinoplasty patients; su rvival has been uniformly complete even when the donor tissue has been scarred or burned. All rhinoplasties were performed endonasally, howe ver; the survival of this flap performed simultaneously with open rhin oplasty has not been established.