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Benjamin E. Saltman, MD; Steven J. Pearlman, MD

Arch Facial Plast Surg. 2009;11(2):114-118.

Objective  To evaluate the incidence of alarplasty in primary and revision rhinoplasty during a 3-year period.

Methods  We conducted a retrospective medical record review of patients undergoing primary and revision rhinoplasty between January 1, 2004, and December 31, 2006. Patients were divided into the following categories: primary or revision rhinoplasty, alarplasty, and ethnicity. The incidence of alarplasty was calculated and compared for primary vs revision rhinoplasty and for ethnicity. Statistically significant differences were confirmed using the ² test.

Results  A total of 168 patients underwent rhinoplasty with minimum follow-up of 6 months; 116 patients had primary rhinoplasty and 52 revision rhinoplasty. All alarplasties were bilateral. Of 50 alarplasties performed, 35 were in the primary group and 15 in the revision group. The incidence of alarplasty was 30.2% in the primary group and 28.8% in the revision group. Nonwhite patients had a higher overall incidence of alarplasty (63.0%) than did white patients (25.4%). Each ethnic category identified had a higher incidence of alarplasty than the white group.

Conclusions  Alarplasty is an important technique in rhinoplasty. The high incidence of alarplasty in revision rhinoplasty procedures suggests that alarplasty is underused by many surgeons currently performing rhinoplasty. One should consider alarplasty for all patients' noses, not just those of nonwhite ethnic rhinoplasty patients.

Author Affiliations: Department of Otolaryngology–Head and Neck Surgery, Columbia University College of Physicians and Surgeons (Dr Saltman), and Division of Head and Neck Surgery, Department of Surgery, Memorial Sloan-Kettering Cancer Center (Dr Pearlman), New York, New York. Dr Pearlman is now with the Department of Otolaryngology– Head and Neck Surgery, Columbia University College of Physicians and Surgeons.