Clinical study on the correction of moderate to severe alar margin retraction using the anterior auricular triangular fossa composite tissue flap

LI Xing; YIN Weimin

doi:10.3969/j.issn.1673-7040.2026.01.005

Abstract：Objective To evaluate the clinical efficacy of the anterior auricular triangular fossa composite tissue flap in the cor-rection of moderate to severe alar margin retraction.Methods A retrospective analysis was conducted on 32 patients(60 sides)with mod-erate to severe alar margin retraction who were treated at Shenzhen Guanghe Outpatient Department from December 2023 to January 2025.Remove the auricular composite tissue flap from the preauricular triangular fossa.Make an incision on the mucosal side of the vestibule,fully release the tension near the alar margin to expose the"transplant bed".Adjust the composite tissue flap to an appropriate position,pass through the tissue flap and the alar skin,and intermittently suture the incision and the composite tissue flap.Follow-up assessments were carried out at 1,3,and 6 months postoperatively to evaluate clinical outcomes.Nasal alar retraction distance was objectively quantified using a three-dimensional digital imaging system,ensuring high precision and reproducibility.Patient-reported satisfaction and indepen-dent expert evaluations were obtained from two board-certified rhinoplasty surgeons who had no involvement in the surgical procedure.These assessments focused on nasal rim appearance and symmetry,measured using the visual analogue scale(VAS),thereby providing a multi-perspective and reliable appraisal of aesthetic outcomes.Results Statistically significant improvements were observed when com-paring preoperative outcomes with those immediately postoperatively and at each follow-up time point(all P＜0.05).However,no statistical-ly significant differences were found among the postoperative follow-up groups(all P＞0.05),indicating stable long-term results.Six months after the operation,the satisfaction rate of patients with the appearance of the nasal alar margin was 90.63％(29/32).The satisfaction rates of the two physicians were 100％(32/32)and 96.88％(31/32),respectively.The satisfaction rate of patients with the symmetry of the alar margin was 90.63％(29/32).The satisfaction rates of the two physicians with the symmetry of the alar margin were 84.38％(27/32)and 90.63％(29/32),respectively.Conclusion The use of the anterior auricular triangular fossa composite tissue flap is a safe and reliable surgical technique for correcting moderate to severe alar margin retraction.