Nasal Base Reduction By Guided Suture Technique (A Report Of 23 Cases)

Objective Nowadays it usually uses alar excision to reduce nasal base which has defect of scar formation in oriental, even with scar hyperplasia. To evaluate the guided suture technique and explore a minimally invasive method of alar base reduction by collecting 23 cases, in order to avoid the defect and enhance satisfaction after surgery.Methods Twenty-three cases had received this operation. Among these cases, 21 were female, 2 were male, the age range from 19 to 59 years old. The operation was performed under local anesthesia .A minimal incision(about 2mm) was made at the lower 1/3 point of the two sides alar groove. Two 4# silk sutures were used. At one end of each suture, a little silicone prosthesis(4mm×2mm×2mm, you can augment the prosthesis if alar groove needs to be fill in)was fixed. Then, entering into the incision, the sutures were parallelized(in different paths) guided to the other side incision by a straight needle(8×55) through the base of nasal alar. After the suture was guided to the other side, the other end of each suture was pulled in contrary direction to reduce the width of the nasal basis. When the appropriated reduction was obtained, ligation was made. Finally, the ligation knot and the silicone prothesis were embeded subcutaneously. No stitch. Some antibiotics were taken after operation. They were followed up for three to twelve months. Results Twenty-three cases were all followed up. All the wounds got grade A healing, and the incision marks were completely disappeared after 3-5 weeks. In 1 case, however, there was an inflammatory granuloma (2mm×2mm×2mm) at the right side wounds 9 weeks after the operation. After removing the sutures and silicone prosthesis, this case recovered completely. The form of basis nasi were made to be equilateral triangle in 20 cases(87%), close to equilateral triangle in 3 cases(13%). The results were very perfect in 20 cases,and 2 cases were general satisfied, the case with inflammatory granuloma seemed not so satisfied with her nasal base.Conclusion The method of guiding suture is effective and easy to perform. No suture, no postoperative scar formation. Patients, especially orientals will prefer to accept this procedure.