An alar retraction is a lifted alar which is the name for the outer side of the nostril that curves around and attaches to the cheek. In general, alar should attach to the cheek about two millimeters above the midline of the nostril. If it’s higher than that, it can cause a triangular look to the nostril, and some people feel it gives them an angry look.
What causes alar retraction after rhinoplasty?
The cause of alar retraction after rhinoplasty is often the weakening of the lower lateral cartilages which are the cartilages that are in the tip and go out toward the side wall of the nostril where it meets the cheek. They’ve either been resected, so they’re smaller and not able to provide the structure that the alar needs, or in some cases, they are completely removed or repositioned higher on the nostril. The farther the cartilage from the actual edge of the nostril, the less structure is given to that nostril.
What is a retracted alar?
A retracted alar is the outer edge of the nostril attaching to the cheek higher than two millimeters above the midline of the nostril. If you were to look at the nose from the side and draw a line from the tip to the outside edge of the nostril, that edge should be two millimeters above the tip. If it’s higher than that, it’s retracted.
How do I lower my alar?
Surgery is required to lower the alar where cartilage or cartilage and skin are taken from another location in the body such as the septum, ear, or rib, and placed inside the nose to reconstruct.
If too much cartilage has been removed during a rhinoplasty, we can reconstruct that lower lateral cartilage. We can even do what we call a composite graft where we take ear and skin from the ear and place that inside the nose to reconstruct that cartilage and surrounding skin including the mucosa, to push the alar back down to where it is naturally located.
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About Dr. Angela Sturm
Dr. Angela Sturm is a double-board certified facial plastic surgeon with certifications with the American Board of Otolaryngology – Head and Neck Surgery and the American Board of Facial Plastic Surgery. Dr. Sturm’s meticulous nature makes for exceptional results and satisfied patients. Dr. Sturm was named Texas Monthly’s Super Doctors Rising Star in 2016-2017, Texas Monthly’s Super Doctor in 2018-2019, H Texas Magazine’s Top Doc in 2013-2018, Top Doc by Houstonia magazine in 2016-2018, Houston Business Journal’s People on the Move and 40 under 40, Blazing Star Award by Texas Women’s Chamber of Commerce, Top Women in Business, one of the Top 30 Influential Women of Houston, Best Female Cosmetic Surgeon in Out Smart, and given the Patients’ Choice Award, On Time Doctor Award and Compassionate Doctor Award by Vitals.com.