The authors present the findings of a retrospective study including 621 patients who had septorhinoplasty using lateral crural repositioning (LCrep) with lateral crural strut grafting (LCSG) and with or without alar base resection. Study participants’ skin types were determined intraoperatively and divided into three groups: 1) thick skin (the tip definition was limited by skin thickness and subcutaneous tissue); 2) thin skin (the tip cartilage was visible and could be observed despite overlying soft tissue and skin); and 3) normal skin. In patients with thin skin, there was no significant difference in the incidence of alar base resection associated with LCrep with LCSG while in patients with thick skin, a significant difference in the frequency of alar base resection was associated with the application of LCrep with LCSG. The conclusion of the study is that the necessity of alar base reduction after LCrep with LCSG is greater in patients with thick skin than in patients with thin and normal skin. This article was the first study to examine this topic in rhinoplasty. 

Association of skin thickness with alar base reduction in patients undergoing lateral crural repositioning and strut grafting.
Ilhan AE, Sozen T, Eser BC, Cengiz B.
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