Modified alar cinch suture technique with Le Fort I osteotomy: A literature review of nasal soft-tissue changes

Le Fort I osteotomy (LFI) can cause undesirable facial changes, including nasal widening. Alar cinch sutures are commonly used to reduce these effects, with varying efficacy. Herein, a modified cinch suture technique is introduced that integrates cartilage, bone, and soft-tissue sling components through bone anchorage. Existing literature on the topic is reviewed. This study included 31 patients (mean age, 30.6 y) who underwent LFI with modified cinch suture placement at our hospital between 2022 and 2024. The suture passed through the nasal septum and soft-tissue sling and was anchored to the bone at point A. The effectiveness of the technique was evaluated using three-dimensional analysis. Key nasal parameters before and 1-y postoperatively were compared using computed tomography. The mean increases in the nasal and alar-base widths were 2.15% and 3.32%, respectively. Nasal tip projection decreased by 6.03%, whereas the nasolabial angle increased by 5.54%. Patient satisfaction was assessed using a survey; 100% and 95% of participants expressed satisfaction with their facial and nasal aesthetics, respectively. Of the 22 studies retrieved from the PubMed database, 14 were included in the analysis. Compared with previously-reported studies, our technique resulted in lesser nasal widening and offered better morphological control. The method represents a novel combination of Rauso Types I–III that provides more comprehensive anchorage and stability. The modified alar cinch suture technique reduces postoperative nasal widening and offers a reproducible, integrative approach to nasal soft-tissue management in orthognathic surgery.