• Journal of the Korean Burn Society
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• v.24 no.2
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• pp.60-63
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• 2021

In the face, the nose plays an important role in both function and appearance. Among the subunits on the nose, the alar is a critical nasal structure of high aesthetic value. Previously, many surgeons have insisted that structural support should be added to the reconstruction of alar and particularly so in the case of a full-thickness defect. In a 58-year-old male patient who had a third-degree burn injury and full-thickness defect in most of the left nasal alar, forehead flap surgery alone was successfully performed without structural support.

• Archives of Plastic Surgery
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• v.38 no.5
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• pp.669-673
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• 2011

Purpose: The authors have conducted a series of anatomic studies on the factors affecting shape of a lower vault in Asian noses. The results of the studies showed that prominence of alar lobule is mainly affected by the volumes of the dilator naris anterior and posterior muscles and the insertions of the dilator naris posterior muscles. However, information on its clinical availability is yet insufficient. The present study was undertaken for clinical purpose to find out the effect of dilator naris muscle resection on the correction of prominent alar lobule. Methods: Six patients who were treated by dilator naris muscle resection with a long-term follow-up of more than 1 year were involved in this study. Rhinoplasties were performed via endonasal approaches with resecting dilator naris anterior and posterior muscles by sharp scissor. The effect of the dilator naris muscle resection on alar prominence was investigated by measuring ratio of the short axis to the long axis of a nostril (SA/LA) pre-and postoperatively. The visual analog scale (VAS) was also used to evaluate satisfaction of patients. An average follow-up time was $15.6{\pm}3.7$ months. Results: Having lost the dilating and lateral pulling effects of the dilator naris muscles, the alar lobule shifted medially and alar lobule shapes improved. SA/LA significantly improved (preoperatively $0.71{\pm}0.11$ and postoperatively $0.58{\pm}0.08$; $p$ <0.05). The VAS score was also increased postoperatively (preoperatively $3.2{\pm}1.8$ and postoperatively $8.7{\pm}1.2$; $p$ <0.05). A mild degree of hyperpigmented scar was noted in one alar lobule. Otherwise, there was no case of postoperative complication. Conclusion: Our results suggest that prominent alar lobule could be modified by resecting the attachment of the dilator naris muscles. This maneuver removes the function of dilator naris muscles, then may produce a more aesthetically acceptable alar lobule shape.

• Archives of Plastic Surgery
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• v.43 no.6
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• pp.604-607
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• 2016

"A smile is happiness you'll find right under your nose"- Tom Wilson. This quote holds true just for patients, not for surgeons. The correction of the nose always poses a challenge to the cosmetic surgeon. Deformities of the external and internal nose may be congenital or acquired and may be secondary to soft tissue and/or osseo-cartilaginous abnormalities, leading to aesthetic and/or functional consequences. Alar flare poses a common problem, sometimes alone and sometimes in conjunction with other external deformities. Alar base reduction is generally considered when the interalar distance exceeds the intercanthal distance. It has been well documented that this simple additional procedure brings about a substantial enhancement in the nose. Various techniques have been described and used in the past, each having their benefits and drawbacks, with the modified Weir wedge excision, Aufricht nasal sill excision, and Bernstein V-Y advancement being the common ones. We hereby describe a technique that is simple yet effective in achieving the desired results and at the same time aims at preventing relapse to obtain satisfactory long term results.

• Archives of Craniofacial Surgery
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• v.22 no.4
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• pp.214-217
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• 2021

Fibrofolliculoma is a benign tumor characterized by a smooth, dome-shaped papule of size 2-4 mm. Most fibrofolliculomas occur as multiple lesions, and very rarely, they are solitary. Herein, we report a case of solitary fibrofolliculoma found in the alar rim, without the typical characteristics of a fibrofolliculoma. A 42-year-old man visited the hospital with a protruding lesion that had occurred 1 year previously. A mass of size 5×7 mm was observed on the left alar rim. The tumor was dome-shaped and palpable. The patient did not have any similar lesions elsewhere. No family member was known to have such a lesion. An incisional biopsy was performed before surgery, and pathological examination revealed hyperkeratosis and dyskeratosis; however, an accurate diagnosis was not made. Complete resection was planned for the mass on the alar rim. The resected mass was subjected to permanent biopsy, and the pathological examination results led to the diagnosis of fibrofolliculoma. Therefore, when diagnosing a dome-shaped mass in the alar rim, despite the suspicion of a very rare disease, it is necessary to suspect fibrofolliculoma and consider the process from diagnostic examination to treatment.

• Proceedings of The Korean Cleft Lip And Palate Association
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• 2002.05a
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• pp.31-31
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• 2002

• Proceedings of The Korean Cleft Lip And Palate Association
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• 2002.05a
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• pp.32-32
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• 2002

• Proceedings of The Korean Cleft Lip And Palate Association
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• 2002.05a
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• pp.24-24
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• 2002

• Archives of Plastic Surgery
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• v.33 no.2
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• pp.135-143
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• 2006

The characteristics of the cleft lip nasal deformity is defined in this article in three planes. The alar flaring is explained in X axis, the lower positioning of the alar free margin is imagined in Y axis and the short hemicolumella is in Z axis. Most cleft surgeons have focused on the malposition of the lateral crus of alar cartilage while the author defined it in X and Y axises and tried to correct that deformity of short hemicolumella in Z axis. For the last 13 years the author applied that method in 818 cases of secondary cleft lip nose deformity. Through the columellar splitting incision extended to free margin of the alar not beyond the nasal dorsum, the skin and soft tissue of the webbing deformed the nasal tip was excised in crescent fashion. The dissected short hemicolumella including the medial crus was thus elevated and advanced into the space of the deformed nasal tip after the crescent excision. This procedure should be followed by the correction of the deformities in X and Y axis. The medial crus elevation is more effective and critical way to have the constant and nice outcome than the lateral crus reposition in secondary cleft lip nasal deformity

• The korean journal of orthodontics
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• v.50 no.2
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• pp.75-85
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• 2020

Objective: The aim of this study was to evaluate changes in the nasal soft tissues, including movements of landmarks, changes in linear distances, and volumetric changes, using three-dimensional (3D) stereophotogrammetry after microimplant-assisted rapid palatal expansion (MARPE) in adult patients. Methods: Facial data were scanned using a white light scanner before and after MARPE in 30 patients. In total, 7 mm of expansion was achieved over a 4-week expansion period. We determined 10 soft tissue landmarks using reverse engineering software and measured 3D vector changes at those points. In addition, we calculated the distances between points to determine changes in the width of the nasal soft tissues. The volumetric change in the nose was also measured. Results: All landmarks except pronasale and subnasale showed statistically significant movement on the x-axis. Pronasale, subnasale, alar right, and alar left showed significant movement on the y-axis, while all landmarks except subnasale showed significant movement on the z-axis. The alar base width, alar width, and alar curvature width increased by 1.214, 0.932, and 0.987 mm, respectively. The average volumetric change was 993.33 ㎣, and the amount of increase relative to the average initial volume was 2.96%. Conclusions: The majority of soft tissue landmarks around the nasal region show significant positional changes after MARPE in adults. The nose tends to widen and move forward and downward. The post-treatment nasal volume may also exhibit a significant increase relative to the initial volume. Clinicians should thoroughly explain the anticipated changes to patients before MARPE initiation.

• Archives of Craniofacial Surgery
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• v.19 no.4
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• pp.260-263
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• 2018

Background: The alar and nasal tip are important subunits of the nose. Determining the optimal procedure for reconstructing a cutaneous defect in a nasal subunit depends on several factors including size, location, and involvement of deep underlying structures. We treated cutaneous defects after tumor ablation in the alar and nasal tip with a local flap, using an S-shaped design and a modified V-Y advancement flap with a croissant shape. Methods: We analyzed 36 patients with skin tumors who underwent flap coverage after tumor ablation. Rotation flaps were used in 26 cases and croissant-shaped V-Y advancement flaps were used in 10 cases. The primary cause of the defects was skin cancer, except for one benign tumor. Results: The mean patient age was 71 years. The size of the defects ranged from $0.49cm^2$ to $3.5cm^2$. No recurrence of skin cancer was noted and all flaps lasted until the end of follow-up. Partial desquamation of the epidermis was noted in one case. The postoperative appearance for most patients was excellent, objectively and subjectively. Conclusion: For cutaneous defects of up to about $4.0cm^2$ of the alar and nasal tip, local flaps using our methods offered a good cosmetic and therapeutic result. The main advantage of our flaps is the minimal dissection required compared to bilobed and other local flap methods. We believe our flaps are a suitable option for alar and nasal tip reconstruction.