The Safety and Outcomes of Simultaneous Open Rhinoplasty, Alar Reduction, and Upper Lip-Lift through One Surgery.

Background: The safety and outcomes of performing a simultaneous Alar reduction, Lip lift, and Open rhinoplasty Surgery (ALOS) through independent incisions have not been reported in any study, therefore, we aimed to evaluate the safety and outcomes of this combination procedure.

Methods: This retrospective review study was conducted on all cases of simultaneous ALOS, lip-lift, and alar reduction performed from 2018-2022, at Facial Plastic Surgery Clinic, New York, USA. Alar reduction involved complete through-and-through resection of alar wedge, and the type of lip lift technique was bullhorn design with excision of skin and Superficial Musculo-Aponeurotic System. Primary open rhinoplasty with inverted V-columellar incision was performed. The follow up period ranged between 4 months to 2 years, but all of patients were followed up at 6 days, one, and two months post-operatively.

Results: Fifty one cases were enrolled. We reviewed criteria of complications including infection, vascular events (such as necrosis, or partial ischemia), and poor scarring, fortunately, we did not have any infection or vascular issues. In 2 cases, columellar scar was "less than optimal", but in all other cases, this scar was "not perceivable" based on the patient survey. In 4 cases, the lip lift procedure scar was considered "less than optimal" showed slight indentation of white scar of lip lift in 9/44 cases. Additionally, all columellar and alar incisions had nearly invisible scarring.

Conclusion: In primary rhinoplasty cases, without any other surgeries or previous trauma in the oronasal region, performing concomitant lip lift, open rhinoplasty, and alar wedge resection is safe and does not negatively affect vascularity or scarring.