Surgery of the nostril

The shape and dimensions of the nostrils are an occasionally underestimated detail in rhinoplasty, but many patients pay considerable attention to this postoperatively. What is relevant is the horizontal and vertical diameter of the nostril, the position and shape of the nasal alar edge, and, last but not least, the symmetry between the two sides. To reduce the height or length of the nasal opening, cartilage transplants or composite grafts from the ear are used. Sill resections are used to reduce the width. Vertical enlargement is achieved through defined skin resection in the vestibule; horizontal enlargement, which can also be indicated for stenoses or revisions of sill resections, is achieved with composite grafts. The edge of the nasal ala can be raised with a vestibular skin resection or a suspension suture of the lateral alar cartilage, and it can be lowered with a rim graft or a transposition of the lateral alar cartilage. Less commonly, a correction of the feet of the medial crura is indicated as a special measure. In the lecture, the techniques are presented in detail and illustrated with examples.