A new surgical method for the correction of unilateral alar base retraction

Aim: Alar base retraction is a challenging deformity to correct, and various approaches have been suggested for fixing it with or without other nasal cone deformities. We focus on the surgical techniques for correcting unilateral alar base retraction, reporting their principles, applicability, and complications, and presenting our new method. Material and Methods: Several established methods are available to correct alar base retraction, including conchal cartilage margin grafting, non-excisional suture techniques, excisional suture techniques, and tissue rearrangement, which can be used alone or in combination Whether utilizing a closed technique or an open technique, we access underneath the periosteum through a small gingival incision made at the level of the canine tooth, and we release the soft tissue by detaching the periosteum from the bone while remaining lateral to the nares. Elevation merges with the elevation of the nasal bone periosteum. The mucosa is sutured using a single stitch. Results: This new technique avoids the major pitfalls of traditional methods, with excellent results and high patient satisfaction. A total of 55 patients were enrolled in this study, and all completed the follow-up. Based on data before and after the operation, clinical outcomes showed significant differences in nostril height (especially on the surgical side compared to the non-surgical side), columellar length, nasolabial angle, and patient satisfaction. Conclusion: Many methods are applicable for correcting alar base retraction, but complete correction without relapse is challenging. New surgical procedures must be developed based mainly on underlying causative factors, alar medialization capabilities without tissue trimming, and strong nasal base support that avoids potential problems, such as limited alar base widening or dislocation of alar base manipulating techniques. These principles do not interfere with or contradict any previous methods. Still, they are instead intended to build upon them and contribute to newer and more standardized results with less relapse. The context of the present techniques will help to understand and give a more concrete idea of comprehension for the newer methods.