Increased projection of the nasal tip with “pseudo-flaps” obtained from lateral cephalic excesses of the alar cartilages

Mr. Editor,

We read with great interest the article with the title: “Increase in the projection of the nasal tip with ‘pseudo-flaps’ obtained from excess cephalic alar cartilages” by Bozola et al. in 2019¹, published in the Brazilian Journal of Plastic Surgery. The authors describe a different technical approach to the projection of the nasal tip, using the resected cephalic portion to reduce alar cartilage in rhinoplasty. The concept of using the alar cartilage itself for reuse in the nose area, as reinforcement of alar cartilage², in use as an expander graft³, in the back filling⁴ or the filling of the soft triangle region⁵ has been described in the current literature and we believe that its reuse, in rhinoplasty techniques, is the ideal way.

According to the description of the results, we would like the authors to comment on the following questions regarding this article:

• First: An increase in the projection of the nasal tip was observed. What was the instrument used to compare and evaluate the projection objectively?

• Second: In increasing the nasal projection, we have several techniques used with sutures and use of grafts, in addition to the technique described, which other techniques were used together in the patients studied?

• Third: In the description, patients reported a satisfactory result. Which instrument was used to measure the pre and postoperative evaluation of these patients?

Finally, we congratulate the authors for their work and innovation regarding the rhinoplasty technique.

• Institution: Hospital de Clinicas UFG, Cirurgia Plástica, Goiânia, GO, Brazil.

REFERÊNCIAS

• ¹
  Bozola AB, Bozola AC, Sommer CG. Aumento da projeção da ponta nasal com "pseudo-retalhos" obtidos dos excessos cefálicos das cartilagens alares. Rev Bras Cir Plást. 2019; 34(4):445-51.
• ²
  Racy E, Fanous A, Pressat-Laffouilhere T, Benmoussa N. The modified sliding alar cartilage flap: a novel way to preserve the internal nasal valve as illustrated by three-dimensional modeling. Plast Reconstr Surg. 2019 Sep;144(3):593-9.
• ³
  Uebel CO, Matta R. Alar cartilage-an alternative for spreader graft in primary rhinoplasty. Eur J Plast Surg. 2017;40(5):417-26.
• ⁴
  Kreutzer C, Hoehne J, Gubisch W, Rezaeian F, Haack S. Free diced cartilage: a new application of diced cartilage grafts in primary and secondary rhinoplasty. Plast Reconstr Surg. 2017 Sep;140(3):461-70.
• ⁵
  Campbell CF, Pezeshk RA, Basci DS, Scheuer JF, Sieber DA, Rohrich RJ. Preventing soft-tissue triangle collapse in modern rhinoplasty. Plast Reconstr Surg. 2017 Jul;140(1):33e-42e.

Publication Dates

• Publication in this collection
  29 May 2023
• Date of issue
  Apr-Jun 2020

History

• Received
  18 Feb 2020
• Accepted
  02 May 2020