Optimizing the Soft Tissue Triangle, Alar Margin Furrow, and Alar Ridge Aesthetics: Analysis and Use of the Articulate Alar Rim Graft

Jennifer L. Goodrich; B. J. F. Wong

doi:10.1055/s-0036-1596049

Facial Plastic Surgery, Table of Contents

Facial Plast Surg 2016; 32(06): 646-655
DOI: 10.1055/s-0036-1596049

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Optimizing the Soft Tissue Triangle, Alar Margin Furrow, and Alar Ridge Aesthetics: Analysis and Use of the Articulate Alar Rim Graft

Jennifer L. Goodrich

¹Department of Facial Plastic and Reconstructive Surgery, University of California Irvine, Orange, California

,

B. J. F. Wong

²Division of Facial Plastic Surgery, University of California Irvine, Orange, California

› Author Affiliations

Abstract

The alar lobule, alar margin, and soft triangle facet are receiving more attention in the literature as critical elements to address both preoperatively and during rhinoplasty. We have found that the use of the articulated alar rim graft (AARG) corrects deficiencies in these areas as well as provides mechanical stability to the external valve. In this article, we describe indications for AARG, describe in detail the procedure for AARG placement, and highlight the transformation AARGs can achieve in two illustrated case studies.

Keywords

soft tissue triangle - soft tissue facet - articulated alar rim graft - alar ridge - alar margin furrow

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References

References
1 Toriumi DM. New concepts in nasal tip contouring. Arch Facial Plast Surg 2006; 8 (3) 156-185
2 Ballin AC, Kim H, Chance E, Davis RE. The articulated alar rim graft: reengineering the conventional alar rim graft for improved contour and support. Facial Plast Surg 2016; 32 (4) 384-397
3 Converse JM. The cartilaginous structures of the nose. Ann Otol Rhinol Laryngol 1955; 64 (1) 220-229
4 Natvig P, Sether LA, Dingman RO. Skin abuts skin at the alar margins of the nose. Ann Plast Surg 1979; 2 (5) 428-429
5 Burget G. Discussion: reconstruction of the nasal soft triangle subunit. Plast Reconstr Surg 2013; 131 (5) 1051-1054
6 Ali-Salaam P, Kashgarian M, Persing J. The soft triangle revisited. Plast Reconstr Surg 2002; 110 (1) 14-16
7 Rohrich RJ, Raniere Jr J, Ha RY. The alar contour graft: correction and prevention of alar rim deformities in rhinoplasty. Plast Reconstr Surg 2002; 109 (7) 2495-2505 , discussion 2506–2508
8 Gruber RP, Fox P, Peled A, Belek KA. Grafting the alar rim: application as anatomical graft. Plast Reconstr Surg 2014; 134 (6) 880e-887e
9 Kayabasoglu G, Nacar A. The soft triangle: an often neglected area in rhinoplasty. Aesthetic Plast Surg 2015; 39 (5) 659-666
10 Chiu-Collins LL, Furze AD, Wong BJF. Caudal septal extension grafts. In: Shiffman MA, Di Giuseppe A, , eds. Advanced Rhinoplasty: Art and Techniques. Berlin Heidelberg: Springer-Verlag; 2013
11 Davis RE. Lateral crural tensioning for refinement of the wide and underprojected nasal tip: rethinking the lateral crural steal. Facial Plast Surg Clin North Am 2015; 23 (1) 23-53
12 Perkins SW, Sufyan AS. The alar-spanning suture: a useful tool in rhinoplasty to refine the nasal tip. Arch Facial Plast Surg 2011; 13 (6) 421-424