الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The shape and anatomical position of the nose are major determinants of overall facial harmony and aesthetics as nose is the central part of a face. Outcomes in rhinoplasty are based on comprehensive pre-operative nasal analysis including evaluation of nasofacial proportions and systematic nasal analysis, mastery of nasal anatomy, facial photography and understanding the consequences of each surgical maneuver. The correction of the nose always poses a challenge to the cosmetic surgeon. Although the results of ABR are gratifying, many surgeons are reluctant to perform such excisions for fear of obvious scarring and/or unnatural results. Alar Base Reduction is performed as the final step in rhinoplasty because any narrowing of the nasal tip or any change in tip projection will have a direct effect on the alar base configuration. Only after the closure of all rhinoplasty incisions can the amount of alar base narrowing be judged properly. Classically, a vertical line dropped from each inner canthus alongside the nose should define, in most ethnic types, the lateral limits of the ala for an ideal normal appearance on frontal view, wider or more flaring ala suggest consideration for ABR techniques. The most common deformities requiring alar base modification include wide nasal base, alar flaring, large nostril size, and asymmetries of nostrils or ala. Alar base surgery that aims to create an aesthetically balanced alar base is an important supplementary surgical technique in rhinoplasty. Rhinoplasty that includes alar base surgery is particularly suitable for patients with a wide ala (defined as an interalar distance that exceeds the intercanthal distance), a flared alar, and/or an asymmetric nostril base. Various techniques have been described and used in the past, each having their benefits and drawbacks, with the wedge excision, nasal sill excision, cinching suture technique and Bernstein V-Y advancement being the common ones. It is important to understand the pathophysiology of the alar base of the nose and its structure to choose the most appropriate technique for Alar Base Reduction to have the best functional and aesthetic outcomes. In this study we choose patients with wide nostrils undergo Nostril Sill Reduction, patients with alar flaring undergo Alar Base Reduction and patients with both (alar flaring and wide nostrils) undergo combined alar base and nostril sill reduction. Eventually evaluation of function, satisfaction and scar in our patients 3 months after this operation is so important to find out a better way to increase the functional, aesthetic consequences of patients in our society. The evaluation of results executed through the utilization of the Nasal Obstruction and Symptom Evaluation (NOSE) and the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) questionnaires, both of which are patient-reported outcome measures (PROMs) validated in identifying nasal obstruction and assessing nasal functional and aesthetic parameters. Subjective measures such as the NOSE score and SCHNOS score collected from our patients in the current study proved that Functional and aesthetic outcomes improved in all 3 groups post operatively compared to pre-operative data.