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Aesthetic Surgery

Sliding Alar Cartilage (SAC) Flap

A New Technique for Nasal Tip Surgery

Ozmen, Selahattin MD; Eryilmaz, Tolga MD; Sencan, Ayse MD; Cukurluoglu, Onur MD; Uygur, Safak MD; Ayhan, Suhan MD; Atabay, Kenan MD

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From the Department of Plastic, Reconstructive and Aesthetic Surgery and Hand Surgery, Gazi University Faculty of Medicine, Ankara.

Received September 13, 2008, and accepted for publication, after revision, November 14, 2008.

Presented at the 19th Annual Meeting of European Association of Plastic Surgeons (EURAPS); May 19–29, 2008; Madeira, Portugal.

Reprints: Selahattin Ozmen, MD, Department of Plastic Surgery, Gazi University Hospital, 14th floor, Besevler 06500, Ankara. E-mail:[email protected].

Annals of Plastic Surgery63(5):p 480-485, November 2009. |DOI:10.1097/SAP.0b013e31819538a8

Abstract

Congenital anatomic deformities or acquired weakness of the lateral crura of the lower lateral cartilages after rhinoplasty could cause alar rim deformities. As lower lateral cartilages are the structural cornerstone of the ala and tip support, deformities and weakness of the alar cartilages might lead to both functional and esthetic problems. In this article, we are introducing sliding alar cartilage flap as a new technique to reshape and support nasal tip.

One hundred sixty consecutive patients between 18 and 55 years of age (mean age: 27.51) were included in the study between January 2007 and May 2008. Of the total number of patients 60 were male and 100 of them were female. None of the patients had rhinoplasty procedure including lower lateral cartilage excision previously.

Sliding alar cartilage technique was used in an open rhinoplasty approach to shape the nasal tip in all patients. This technique necessitates about 2 to 3 minutes for suturing and undermining the alar cartilages. The follow-up period was between 4 and 18 months. In no patients any revision related to the sliding alar cartilage technique was required. Revision was applied in 3 patients due to thick nasal tip skin and in one patient due to unpleasant columellar scar.

In this article, we are presenting the “sliding alar cartilage flap” as a new technique for creating natural looking nasal tip. This technique shapes and supports nasal tip by spontaneous sliding of the cephalic portion of the lower lateral cartilage beneath the caudal alar cartilage, with minimal manipulation, without any cartilage resection, or cartilage grafting.

© 2009 Lippincott Williams & Wilkins, Inc.

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Annals of Plastic Surgery63(5):480-485, November 2009.
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