Video 4.3: Double Layer Graft for Alar Rim Retraction Located Medially

What this video shows

Video 4.3 demonstrates the double layer graft, which the book describes as the most suitable repair when the alar rim retraction is located medial to the area where the rim is tangent to the lower lateral cartilage. Two layers of cartilage graft support and lower the rim and restore a natural nostril image; the accompanying figures show the patient before and 2.5 years after surgery.

The technique was published by the author, and it sits within an algorithm that ranges from simple rim grafts for mild cases, through V-Y advancement (Video 4.2) for moderate lateral retraction, to composite auricular grafts for severe deformities.

Key points

• Indication: alar rim retraction with a medial location.

• Two cartilage layers support and lower the rim.

• Long-term result documented at 2.5 years.

In the book: Chapter 4 – Nasal Tip Surgery, section 4.2.3 Nostril Image, pp. 77–78 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.