Application of scalp graft in the correction of severe alar retraction

Abstract

Background: Alar retraction is characterized by excessive nostril exposure and presents a significant challenge in rhinoplasty, particularly in cases of severe alar retraction. This study aimed to introduce a novel treatment approach for severe alar retraction using a scalp graft.

Methods: A retrospective study was conducted on 18 patients with severe alar retraction, defined by the extent of nostril exposure in the frontal view relative to the facial surface, who underwent revision rhinoplasty between May 2022 and May 2023. Scalp grafts were used to address severe alar retraction. Postoperative outcomes were assessed using the rhinoplasty outcomes evaluation (ROE) scale and visual analog scale (VAS) for patient satisfaction.

Results: Postoperative assessments revealed significant improvements in the ratio of the distance from the nasal base midline to the alar edge in the frontal view relative to the corresponding distance in the basal view (P < 0.05); significant improvements were notes in ROE and VAS scores as well (P < 0.05). All patients reported satisfaction with the overall aesthetic outcomes of the surgery, and no significant complications were observed during the follow-up period.

Conclusion: The use of scalp grafts correcting severe alar retraction is a feasible and innovative approach. Key advantages include a skin tone that closely matches that of the nasal vestibule, concealed scar, and excellent graft survivability.

Keywords: Graft; Rhinoplasty; Scalp; Severe alar retraction.