Objective: To evaluate the role of creating an alar-based advancement flap in narrowing the nasal base and correcting excessive alar flare.
Study design: Case series with chart review.
Setting: This is a retrospective record review study.
Subjects and methods: The study included 35 cases presenting with a wide nasal base and excessive alar flaring. The surgical procedure combined the alar base reduction with alar flare excision by creating a single laterally based alar flap. Any caudal septal deformities and any nasal tip modification procedures were corrected before the nasal base narrowing. The mean follow-up period was 23 months.
Results: The mean alar flap narrowing was 6.3 mm, whereas the mean width of sill narrowing was 2.9 mm. This single laterally based advancement alar flap resulted in a more conservative external resection, thus avoiding alar wedge overresection or blunting of the alar-facial crease. No cases of postoperative bleeding, infection, or keloid were encountered, and the external alar wedge excision healed with no apparent scar that was hidden in the depth of the alar-facial crease. The risk of notching of the alar rim at the sill incision is reduced by adopting a 2-layer closure of the vestibular floor.
Conclusion: The alar base advancement flap is an effective technique in narrowing both the nasal base and excessive alar flare. It adopts a single skin excision to correct the 2 deformities while commonly feared complications were avoided.