LAUSR

INTRODUCTION Alar flare reduction (AFR) is a widely utilized technique in rhinoplasty. While the impact of AFR on the alar base has been well studied, its effect on the surrounding tissues is largely unknown. This study aims to elucidate the potential effect of AFR on the overall nasal and peri-nasal anatomy. METHODS AFR was performed on cadavers (n=7) with sequential crescent shaped alar excisions of 2, 4 and 6mm. 2D and 3D-photographs were obtained at baseline and subsequent intervals. Analysis was performed with Adobe Photoshop and Vectra. Standardized landmarks were placed at the nasal tip point (NTP) and alar base point (ABP) to quantify NTP vector distances, NTP surface distances, and alar crease angle. RESULTS The surface and vector distances between the NTP and ABP decreased for increasing AFR intervals. AFR created a surface decrease of 1.90±1.60, 3.54±1.85, and 4.91±1.89mm respectively. AFR created a vector decrease of 1.50±1.14, 2.83±1.37, and 3.97±1.38mm respectively. NTP projection decreased by 0.54±0.31mm for 6mm excision. AFR led to cheek elevation of 0.87±0.70, 1.25±0.60, and 1.96±0.48mm respectively. This alar crease elevation blunted the transition between the cheek and upper lip skin at the level of the alar rim with the angle of this transition increasing 26.62±12.78 degrees from baseline to 6mm. CONCLUSIONS 3D-analysis demonstrates the influence of AFR on the alar base and surrounding peri-nasal contour. AFR results in nasal tip de-projection, alar crease elevation, and alar flare width narrowing. Further investigation into the impact of modifying the alar base on surrounding structures is warranted.