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The appropriate surgical management of an alar lobule defect depends upon the dimensions (length, width, depth) of the wound. Anatomically, the nasal skin and the underlying soft tissues of the alar lobule form a semi-rigid aesthetic subunit that forms the graceful curve of the alar rim, and provides unobstructed airflow through the nostrils, the anterior nares.
The major cause of alar retraction is rhinoplasty, which requires surgical correction. The excision or aggressive surgical removal of tissue can be a major cause of alar retraction after rhinoplasty.
After surgery, there will be some swelling. The swelling can take many months to resolve, although most people stop noticing it after a couple of months. People are usually back to performing most activities after a week and resuming all activities after two to four weeks.
Rhinoplasty: A divided section design used in Mohs surgery for excising cancerous lesions before nasal reconstruction.
Therefore, in young patients, the strategic placement (hiding) of the rhinoplastic scars is a greater aesthetic consideration than in elder patients; whose less elastic skin produces scars that are narrower and less noticeable.
The effectiveness of a rhinoplastic reconstruction of the external nose derives from the contents of the surgeon's armamentarium of skin-flap techniques applicable to correcting defects of the nasal skin and of the mucosal lining; some management techniques are the bilobed flap, the nasolabial flap, the paramedian forehead flap, and the septal mucosal flap.
Infraorbital nerve – conveys sensation to the area from below the eye socket to the external nares (nostrils).
The design can you reshape your nose of the bilobed flap derives from the creation of two adjacent random transposition flaps (lobes). In its original design, the leading flap is applied to cover the defect, and the second flap, is emplaced where the skin flexes more, and fills the donor-sitio wound (from where the first cartilage rhinoplasty flap was harvested), which then is closed primarily, with sutures. The first flap is oriented geometrically, at 90 degrees from the long axis of the wound (defect), and the second flap is oriented 180 degrees from the axis of the wound. Although effective, the bilobed flap technique did create troublesome "dog ears" of excess flesh that required trimming and it also produced a broad skin-donor area that was difficult to confine to the nose.
liposuction and anaesthesia, including intravenous sedation and anything more than a low dose of local anaesthetic, must be carried out in a registered private hospital or day procedure centre.
A thorough discussion of the patient's goals, anticipated results, and possible surgical limitations is an essential part of pre-surgical planning.
‘open’ technique – this involves accessing the nasal bones through incisions inside the nostrils and through the columella (the narrow strip of tissue that separates the nostrils at the base of the nose)
The cost of a rhinoplasty depends on several factors, including the complexity of the surgery, the surgeon's training and experience, and geography. At Mayo Clinic, the cost of surgery will be the same regardless of which surgeon you choose.
Depending on what is required and what additional procedures are performed, the surgery may take one to several hours.