{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T13:37:47Z","timestamp":1777642667471,"version":"3.51.4"},"reference-count":14,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2013,7,1]],"date-time":"2013-07-01T00:00:00Z","timestamp":1372636800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["JAMA Facial Plast Surg"],"published-print":{"date-parts":[[2013,7]]},"abstract":"\n Importance<\/jats:title>\n The effect of different rhinoplasty maneuvers on alar retraction remains to be elucidated.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine the etiology and treatment of alar retraction based on a series of specific rhinoplasty maneuvers.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Retrospective review of a single surgeon\u2019s rhinoplasty digital photo database, examining preoperative alar retraction from January 1, 2002, to December 31, 2005, in 520 patients. Patients with more than 1 mm of alar retraction on preoperative photographs were identified. Postoperative photographs were examined to determine the effect of specific rhinoplasty maneuvers on the position of the alar margin; these maneuvers included cephalic trim, cephalic positioning of the lower lateral cartilage, composite grafts, alar rim grafts, alar batten grafts, and overlay of the lower lateral cartilage.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Tertiary care academic health center.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Forty-five patients with alar retraction met inclusion criteria, resulting in 63 nasal halves with alar retraction.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Intraoperative findings, postoperative results.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Forty-seven percent of the patients (n\u2009=\u200921) had prior surgery; 47% also had cephalically positioned lower lateral cartilages. Among patients with less than 4 mm of cartilage width at the outset, 46% of those who received supportive grafts achieved target correction vs only 7% for patients who did not undergo supportive cartilage grafting. In patients who underwent more than 4 mm of cephalic trim, those who received supportive grafts achieved 46% of target correction vs 11% among those who did not. Ninety-five percent of composite grafts, 69% of alar strut grafts, 47% of alar rim grafts, 43% of vertical lobule division, and 12% of alar batten grafts achieved their target correction values.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n Alar retraction is a highly complex problem. It can be seen de novo and is associated with cephalically positioned lower lateral cartilages. Structurally supportive grafting\u2014including composite grafts, alar strut grafts, alar rim grafts, vertical lobule division, and alar batten grafts\u2014can improve alar retraction.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n \n 4<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamafacial.2013.151","type":"journal-article","created":{"date-parts":[[2013,6,6]],"date-time":"2013-06-06T13:03:12Z","timestamp":1370523792000},"page":"268-274","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":37,"title":["Alar Retraction"],"prefix":"10.1177","volume":"15","author":[{"given":"Ashlin J.","family":"Alexander","sequence":"first","affiliation":[{"name":"Division of Facial Plastic & Reconstructive Surgery, Department of Otolaryngology, New York University, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anil R.","family":"Shah","sequence":"additional","affiliation":[{"name":"Private practice in Chicago, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minas S.","family":"Constantinides","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic & Reconstructive Surgery, Department of Otolaryngology, New York University, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,7,18]]},"reference":[{"issue":"4","key":"e_1_3_1_2_2","first-page":"1116","article-title":"Indications and use of composite grafts in 100 consecutive secondary and tertiary rhinoplasty patients: introduction of the axial orientation.","volume":"110","author":"Constantian MB","year":"2002","unstructured":"Constantian MB. 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