Combined Rhinoplasty For Hypertrophy Of Ala Nasi In Oriental Patients:a New Approach Named M-shaped Flap

Objective:Nowadays, an incredible number of people in oriental prefer to have combined rhinoplasty because of saddle nose and nasal alar hypertrophy.In terms of nasal alar hypertrophy, there were two main surgical techniques, namely, respectively narrowing hypertrophy vertically and transversally, which often leaved external marks.Therefore, we’d like to describe the three-dimensional M-shaped flap technique to correct nasal alar hypertrophy and minimize external scars simultaneously.Methods:47female patients and2male patient with the diagnosis of saddle nose and nasal alar hypertrophy received the three-dimensional M-shaped flap technique from Jan.2012to Sep.2014.The mean age was28.6years old (range,18to40).Before the surgery,all of them had already been taken rhinoplasty. The length and height of ala nasi, the length and width of nostril, and the width of nose were measured preoperatively and postoperatively to assess the results.Results:After3to24months follow-up, the average length of the nasal ala were (25.9±1.6) mm before the surgery and (20.8±1.2) mm after operation (p<0.05),the average height of the nasal ala were(15.8±1.2)mm before the surgery and (12.4±1.1)mm after operation (p<0.05),the average length of the nostril were (12.8±0.9) mm before the surgery and (11.6±0.8)mm after operation (p<0.05),the average height of the nostril were(8.3±0.8)mm before the surgery and (6.8±0.7)mm after operation (p<0.05),the average width of nose were (44.8±1.8) mm before the surgery and (38.7±1.5) mm after operation (p<0.05).46cases thought they got successful surgery and cosmetic effects, while3cases(all female patients)believed that they got recurrence of nasal alar hypertrophy, no early complications involving hematoma, infection, skin and mucosal necrosis,or wound dehiscence were encountered.Conclusion:Three-dimensional M-shaped flap for nasal alar hypertrophy could decrease both the length and height of the nasal ala simultaneously. So this method is worthy of clinical promotion with invisible external scars and satisfactory results.