See how an alar rim graft can correct alar retraction and excessive columellar show caused by post-traumatic scarring.

Today I'd like to discuss the case of a patient of mine who suffered extensive facial lacerations in an accident many years ago.

In the photo above you can see that one of his scars extended from his right nasal sidewall to his right nostril. The resulting scar contracture then led to right alar retraction in which the nostril margin is elevated on that side. As the lower lateral cartilage retracted upward its ability to support the nostril margin is compromised. The schematic below shows this process.

What is an alar rim graft?

There are several ways of treating alar retraction. One method to address alar retraction is to place an alar rim graft. An alar rim graft is a long, relatively thin piece of cartilage that is inserted along the nostril (alar) margin where it is able to support the tissue in the area and bring down the retracted area.

This schematic shows where a rim graft is placed:

Before and after rim graft rhinoplasty photos

Want to see what a rim graft can do? Check out the series of photos below:

Using a hidden closed incision I was able to place an alar rim graft that was carved using the patient's septal cartilage. You can see how the patient's excessive columellar show is much improved in the after photo on the right.

The frontal view photos above further shows how the rim graft placement was able to create better symmetry as the right nostril margin was brought down with the rim graft.

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