Mb. Constantian, AN ALAR BASE FLAP TO CORRECT NOSTRIL AND VESTIBULAR STENOSIS AND ALARBASE MALPOSITION IN RHINOPLASTY, Plastic and reconstructive surgery, 101(6), 1998, pp. 1666-1674
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.