Buried-guided suture suspension of the alar crus: A minimally invasive method to correct nostril exposure

J Plast Reconstr Aesthet Surg. 2024 Nov 29:101:40-45. doi: 10.1016/j.bjps.2024.11.056. Online ahead of print.

Abstract

Objectives: To introduce a novel technique using the buried-guided suture method for suspending the alar crus to correct nostril exposure in East Asians and to investigate its safety and efficacy.

Methods: Patients with ptotic alar crus and nostril exposure at our clinic were enrolled between December 2011 and December 2023. Via an intranasal incision, the excess skin on the inner side of the nostrils was excised. The alar crus was suspended to the periosteum of the piriform aperture using non-absorbable sutures. Changes in the exposed area of the nostrils and distance of alar crus elevation were statistically analyzed before and after surgery. Satisfaction rate was assessed using a four-point visual analog scale.

Results: A total of 35 patients were included, with an average follow-up duration of 15 ± 6 months. Post-operatively, the mean exposed area of the nostrils was significantly reduced compared to the preoperative area (9.14 ± 1.93 mm² vs. 20.97 ± 2.64 mm², P < 0.05). The mean height of the alar crus relative to the base of the columella showed significant improvement post-operatively (+1.08 ± 0.32 mm vs. -1.82 ± 0.32 mm, P < 0.05). Overall, 91.4% (32/35) patients expressed satisfaction with the outcomes.

Conclusions: The buried-guided suture method for suspending the alar crus combined with excision of the inner nasal skin is a safe and effective surgical procedure for correcting nostril exposure.

Keywords: Alar crus; Buried-guided suture suspension; Nostril exposure.