Video 4.2: V-Y Advancement Flap for Moderate Alar Rim Retraction

What this video shows

Alar rim retraction, often seen in secondary rhinoplasty patients, is treated according to its severity and location. Video 4.2 shows the V-Y advancement flap used for moderate retraction when the retracted area lies lateral to the point where the rim is tangent to the lower lateral cartilage; the soft tissue content of this area allows the flap to be advanced and the rim to be lowered.

For mild retraction a rim graft placed in a pouch is sufficient, and for retraction located medially the double layer graft of Video 4.3 is the technique of choice; severe cases need auricular composite grafts. Table 4.2 in the book lists all nostril deformities with their treatment options.

Key points

• Indication: moderate alar rim retraction, lateral location.

• V-Y advancement of the vestibular soft tissue lowers the rim.

• Part of the book's nostril deformity treatment table.

In the book: Chapter 4 – Nasal Tip Surgery, section 4.2.3 Nostril Image, pp. 76–77 of Rhinoplasty in Practice: An Algorithmic Approach to Modern Surgical Techniques (CRC Press, 2021). About the book and all companion videos.

Surgeon: Prof. Dr. Suleyman Tas, plastic, reconstructive and aesthetic surgeon, Istanbul. This video is part of the surgeon-training material of the book; patients considering rhinoplasty in Istanbul can use it to understand the techniques used at Prof. Dr. Suleyman Tas Clinic.