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The following is a summary of “Application of scalp graft in the correction of severe alar retraction,” published in the March 2025 issue of An International Journal of Surgical Reconstruction by Zeng et al.

Alar retraction, characterized by excessive nostril exposure, poses a significant aesthetic and functional challenge in rhinoplasty, particularly in severe cases. This study introduces a novel approach utilizing scalp grafts for the correction of severe alar retraction and evaluates its clinical outcomes. A retrospective analysis was conducted on 18 patients with severe alar retraction who underwent revision rhinoplasty between May 2022 and May 2023. The severity of alar retraction was determined based on the extent of nostril exposure in the frontal view relative to the facial surface. Scalp grafts were employed to restore alar contour and achieve a more balanced nasal appearance. Postoperative outcomes were assessed using the Rhinoplasty Outcomes Evaluation (ROE) scale and the Visual Analog Scale (VAS) for patient satisfaction. 

Objective morphometric analysis was also performed by measuring the ratio of the distance from the nasal base midline to the alar edge in the frontal view relative to the corresponding distance in the basal view. Statistical analyses demonstrated significant improvements in these morphometric parameters postoperatively (P<0.05), confirming the efficacy of the technique. Additionally, both ROE and VAS scores showed significant postoperative enhancements (P<0.05), indicating high levels of patient satisfaction. Notably, all patients expressed a positive perception of their surgical outcomes, and no major complications, such as graft failure, infection, or excessive scarring, were observed during the follow-up period. The scalp graft technique offers several key advantages, including a skin tone closely matching that of the nasal vestibule, minimized donor site morbidity, and optimal graft survivability. 

Furthermore, the concealed donor site ensures an aesthetically favorable outcome. These findings suggest that scalp grafting is a viable and innovative option for correcting severe alar retraction in revision rhinoplasty cases, offering both functional and aesthetic benefits. Further research with larger cohorts and long-term follow-up is warranted to validate these results and establish standardized protocols for optimal graft integration and postoperative care.

Source: jprasurg.com/article/S1748-6815(25)00190-1/abstract