Evaluation of Scar Outcome After Alar Base Reduction Using Different Surgical Approaches

Jibril Y Hudise, Saud A Aldhabaan, Raad S Nassar, Ahmed M Alarfaj
Journal of Oral and Maxillofacial Surgery 2020, 78 (12): 2299.e1-2299.e8

PURPOSE: Alar base reduction was first performed in 1892, when Robert Weir began performing surgery to correct nasal flaring. Our study objective was to investigate scar outcomes after alar base reduction with different surgical approaches.

MATERIALS AND METHODS: We performed a retrospective cohort study of patients who underwent alar base reduction at King Abdulaziz University Hospital. The primary predictor variable was wound incision in the alar-facial groove; other variables were age, gender, and time interval. The outcome variable, scar status, was assessed subjectively (unnoticeable, noticeable but acceptable, or noticeable and unacceptable) and objectively by rhinoplasty surgeons using Stony Brook Scar Evaluation Scale scores. Paired t tests were used, with P ≤ .05 considered statistically significant.

RESULTS: A total of 70 patients were included, with 35 in each of 2 groups. The incision for alar reduction was placed in the alar-facial groove in group 1; the incision was placed 1 to 2 mm anterior to the alar-facial groove in group 2. Group 1 consisted of 14 men (40%) and 21 women (60%); group 2 consisted of 8 men (22.9%) and 27 women (77.1%). The average Stony Brook Scar Evaluation Scale scores for groups 1 and 2 were 4.62 and 4.48, respectively, and did not differ significantly (P = .196). During subjective scar assessment, 85.7% of patients from group 1 reported that their scars were unnoticeable whereas 14.3% reported that they were noticeable but acceptable. In group 2, 82.9% of patients reported unnoticeable scars whereas 17.1% reported noticeable but acceptable scars. Thus, no significant differences were observed in the subjective assessment between the 2 groups (P = .286).

CONCLUSIONS: Alar resection along the alar-facial groove ensures better scar outcomes and hides the scar within that groove, especially in patients with a deep facial groove. Future studies should focus on the best method for limiting scarring in patients without deep facial grooves.

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