What Is The Best Way To Do Nostril Repositioning After A LeFort 1 Osteotomy?

Q: Dr. Eppley, I have had upper jaw advancement surgery, and surgeon did not do alar cinch. My nose has remained the same apart from horribly flared nostrils. They flare outwards and upwards so that frontways on – my nostrils are higher either side than the tip, and they look open from the sides. I have since had alar base reduction which has helped a little but the still flare upwards at the sides. If I pull down under each nostril my nostrils look normal again. Therefore I feel I need the cinch to be done as a stand alone procedure. Please can you advise if and how this can be done..and should I approach a jaw surgeon or a nose surgeon? My previous jaw surgeon is not very helpful and states he has only eve done cinch as part of jaw operation. Many thanks

A: An alar cinch procedure is not the correct procedure for dealing with either horizontal or vertical malposition of the nostrils after a LeFort I osteotomy. That is only a preventative procedure done at the closure of a LeFort I osteotomy, Nostril repositioning by sill or nasal base skin excision is the definitive procedure to change nostril position either flaring or vertical malposition.

Dr. Barry Eppley

Indianapolis, Indiana