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A modified alar cinch suture technique. Article (PDF Available) in European Journal of Plastic Surgery 32(6) · December with. Next, small amounts of the solution are injected beneath the alar bases and the nasolabial To control the width of the alar base, an alar cinch suture is used. Secondary changes of the nasolabial region after the Le Fort I osteotomy procedure are well known and include widening of the alar base of the nose, upturning.

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Introduction Le Fort 1 intrusion osteotomies are known to cause adverse effects on the oro-facial soft tissues such as broadening of the alar base, loss of vermillion show of the upper lip and down sloping of the commissure [ 1 ]. Hari Kishore Bhat, Email: Alar cinch suture restores the normal alar width by preventing the lateral drift of the naso-labial muscle and thereby reducing the postoperative nasal flare significantly.

The dissection may move on superiorly to the infraorbital rim. Many studies have shown significant changes in soft tissue nasolabial morphology associated with Le Fort I osteotomy, 1 – 4 one of which is an increase in the width of the alar base of the nose.

The vertical height of the incision line leaves an inferior cuff of moveable mucosa and buccinator muscle on the alveolus that will facilitate closure.

InShams and Motamedi presented another modification of the alar cinch technique. Comparison of two techniques of cinch suturing to avoid widening of the base of the nose after Le Fort I osteotomy. Published online Dec Articles from Eplasty are provided here courtesy of Open Science Co. Author information Copyright and License information Disclaimer.


National Center for Biotechnology InformationU. Other contributing factors include detachment of muscle insertion from its origin and the muscle tends to reattach at a shortened length because of contraction.

The tip of the nose turns upwards, the naso-labial angle might increase and the maximal alar width increases. Superior repositioning of the maxilla causes elevation of the nasal tip, widening of the alar bases, and a decrease in the naso-labial angle [ 4 ]. The sutures are cut short, the forcep is released, and the knot can dig into the tissue channel made by the needle.

AO Surgery Reference

J Maxillofac Oral Surg. The maxillary vestibular approach is simple and safe, as long as the dissection proceeds strictly in the subperiosteal plane.

In the edentulous maxilla, where the alveolar crest and the nasal floor converge due to laar bone atrophy, the incision should be placed along the base of the alveolar crest. We believe that the strength of our modified technique is based on its simplicity and consistency; the midline cimch anchored to the hole in the nasal spine allows a more symmetric result and avoids the problem of an infection or a foreign body reaction in the skin.

Acknowledgments Appreciation is extended to Mrs.

An Alternative Alar Cinch Suture

J Oral Maxillofac Surg. Mean and standard deviation cich pre—post operative comparison in groups 1 and 2 and Paired sample t test in groups 1 and 2 to determine p value.

Please review our privacy policy. This creates a pout in the midline of the upper lip, creates volume, and everts the vermillion.

Abstract Nasal widening is commonly associated to maxillary osteotomies, but it is only partially dependent on the amount of skeletal movement. Received Apr 28; Accepted Oct To achieve a good hemostatic effect, vasoconstrictive agents are applied at least 10 to 15 minutes before beginning surgery.

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In the sample, there were 13 men and 19 women, average age There are various adjunctive procedures but no evidence to suggest the efficacy of each adjunctive procedure advocated to minimize nasal changes.

Use of the alar base cinch suture in Le Fort I osteotomy: is it effective?

The alar flare resulting from every millimeter of impaction was significantly less in group 2 compared to group 1. O’Ryan Sutur, Schendel S. The post-operative results in group 2 compared to pre-op, frontal and sub-nasal suhure, is depicted in Figs. The suture is pulled back and forth several times until it is embedded under the skin into the dermis to prevent an unsightly dimple.

The anterior nasal spine and the lower border of the cartilaginous septum are addressed by soft-tissue retraction with a forked angle retractor and the perichondrium on top of the cartilaginous septal border is incised. All the patients had bimaxillary operations, with or without genioplasty.

Infraorbital nerve Nasolabial musculature Buccal fat pad Pterygoid venous plexus Zygomaticofacial nerve Vasoconstriction. Bell and Profit suggested that at time of preoperative assessment, patients with a wide nose be warned that a rhinoplasty may be indicated in the near future [ 4 ]. General consideration The maxillary vestibular approach is simple and safe, as long as the dissection proceeds strictly in the subperiosteal plane. Nasal anatomy and maxillary surgery.