Correction of Severe Alar Retraction with Use of a Cutaneous Alar Rotation Flap

Background: Severe alar retraction is one of the most challenging problems to correct in nasal surgery. Management for severe alar retraction traditionally requires multiple stages and uses several surgical techniques. This article introduces a single-stage technique to correct severe alar retraction deformities using a cutaneous alar rotation flap in conjunction with alar batten grafts. Methods: Patients with severely retracted alae underwent ala reconstruction using a cutaneous alar rotation flap and autogenous cartilage batten grafts. Results: Thirteen patients with severe alar retraction underwent alar reconstruction using cutaneous alar rotation flap and alar batten grafts. The alar retraction was corrected in all cases, achieving improvements functionally and aesthetically. No recurrence of alar retraction was noted. The incision sites for the patients healed with acceptable cosmetic results, with only one patient requiring scar revision. Conclusions: The cutaneous alar rotation flap is an effective and reliable surgical option to correct severe alar retraction. Advantages of this technique include a single-stage approach, ease of design, tissue match, and rich blood supply. Scar from the flap design can be kept inconspicuous by precise placement of the incision within the junction of the ala and the nasal dorsum, following principles of the aesthetic nasal subunits. (Plast. Reconstr. Surg. 123: 1088, 2009.)