The correction of alar-columella web deformities in unilateral cleft-lip nasal deformities with web graft technique.

[BACKGROUND] Among the many secondary deformities in cleft-lip nose, the alar-columella web is unsightly and is a recurrent deformity. The purpose of this article is to revisit the correction of alar web deformity in patients with cleft-lip nasal deformities and to introduce our web graft technique.

[METHODS] Thirteen patients with alar webbing underwent surgery between June 2012 and February 2013. The age range of the patients at the time of surgery was 14-29 years. An open rhinoplasty incision, including a reverse-U incision, was made and cartilage work was performed. After the cleft side was equalized with the dome angle of the healthy side, we used contralateral alar or auricular cartilage grafts as a stiff batten to stabilize the converted web skin. The web graft was fixed to the cleft-side web skin's inner side with at least three sutures to maintain the tucking of the vestibular skin. The follow-up period ranged from 1 to 20 months.

[RESULTS] The postoperative frontal and basal views showed that the nostrils and columella had better shape. Most patients demonstrated correction of the drooping alar rim and satisfactory symmetry of the nostrils.

[CONCLUSION] A web graft supports the vestibular lining of the reverse-U incision and increases the strength of the new concavity of the tucked skin. We expect that a long-lasting concave web contour could be achieved with this technique.