Objective:To investigate the effect of modified alar reduction with external incision to correct alar hypertrophy.Methods:From January 2017 to January 2019, 16 patients(1 male and 15 females, aged 21 to 39 with alar hypertrophy were treated in the plastic surgery department of the Second Affiliated Hospital of Nanchang University. Modified alar reduction with external incision were applied. In order to rotate the free alar lobules, the incision was extended in nasal lobules to the vestibular floor and remove part of the vestibular tissue of the alar lobules during the operation. Then the free alar was moved into the nostril to make the alar junction shift inward and upward, and reposition the alar junction to correct the alar hypertrophy and the wide nasal base. Photos of patients in frontal, side, and basal view before operation, 1 month, 6 months after operation. Intercanthal distance (ICD)、interinter-alar width (IW)、nasal base width (BW) were measured. The ratios of IW, BW and ICD before operation, 1 month, and 6 months after operation, and the narrowing rate of IW and BW at 1 month and 6 months after operation were summarized. The incision scar was evaluated with reference to the Vancouver Scar Scale. Normally distributed variables were compared using an paired t test. Nonparametric continuous variables were compared using Wilcoxon rank sum test. When P<0.05, the difference is considered statistically significant. Results:Sixteen patients were followed up for 6 to 12 months, averaged of 8 months. The IW/ICD of 16 patients at preoperation, after operation 1 month and 6 months were 1.160±0.080, 1.049±0.047 (0.110±0.049 decrease than before operation) and 1.038±0.047 (0.120±0.049 decrease than before operation). The differences were statistically significant ( P<0.05). The IW constriction rates were 9.3% at 1 month after operation and 10.2% at 6 months after operation. BW/ICD at preoperation, after operation 1 month and 6 months were 1.035±0.047, 0.960±0.039(0.072±0.019 smaller than preoperation), and 0.950±0.034(0.079±0.020 smaller than preoperation). Compared with preoperative data, the difference was statistically significant ( P<0.05). The BW reduction rates were 7.0% at 1 month after operation and 7.6% at 6 months after operation. The Vancouver Scar Scale score was 3(2.25, 3) at 1 month after operation, 1(0.25, 1) at 3 months after operation and 1(0, 1) at 6 months after operation. The differences were statistically significant ( P<0.05). There was a statistically significant difference between 3 months after surgery and 1 month after surgery ( Z=-3.472, P=0.001). There was no statistically significant difference between 6 months after surgery and 3 months after surgery ( Z=-1.414, P=0.157). All patients had no significant postoperative complications such as incision infection, asymmetry of nasal alae, obstruction of nasal ventilation, etc. Postoperative alar and nasal base profiles were significantly improved. Conclusions:Modified alar reduction with external incision can effectively treat alar hypertrophy without obvious postoperative complications. It is a good operation to correct alar hypertrophy.

Objective:To investigate the effect of modified alar reduction with external incision to correct alar hypertrophy.Methods:From January 2017 to January 2019, 16 patients(1 male and 15 females, aged 21 to 39 with alar hypertrophy were treated in the plastic surgery department of the Second Affiliated Hospital of Nanchang University. Modified alar reduction with external incision were applied. In order to rotate the free alar lobules, the incision was extended in nasal lobules to the vestibular floor and remove part of the vestibular tissue of the alar lobules during the operation. Then the free alar was moved into the nostril to make the alar junction shift inward and upward, and reposition the alar junction to correct the alar hypertrophy and the wide nasal base. Photos of patients in frontal, side, and basal view before operation, 1 month, 6 months after operation. Intercanthal distance (ICD)、interinter-alar width (IW)、nasal base width (BW) were measured. The ratios of IW, BW and ICD before operation, 1 month, and 6 months after operation, and the narrowing rate of IW and BW at 1 month and 6 months after operation were summarized. The incision scar was evaluated with reference to the Vancouver Scar Scale. Normally distributed variables were compared using an paired t test. Nonparametric continuous variables were compared using Wilcoxon rank sum test. When P<0.05, the difference is considered statistically significant. Results:Sixteen patients were followed up for 6 to 12 months, averaged of 8 months. The IW/ICD of 16 patients at preoperation, after operation 1 month and 6 months were 1.160±0.080, 1.049±0.047 (0.110±0.049 decrease than before operation) and 1.038±0.047 (0.120±0.049 decrease than before operation). The differences were statistically significant ( P<0.05). The IW constriction rates were 9.3% at 1 month after operation and 10.2% at 6 months after operation. BW/ICD at preoperation, after operation 1 month and 6 months were 1.035±0.047, 0.960±0.039(0.072±0.019 smaller than preoperation), and 0.950±0.034(0.079±0.020 smaller than preoperation). Compared with preoperative data, the difference was statistically significant ( P<0.05). The BW reduction rates were 7.0% at 1 month after operation and 7.6% at 6 months after operation. The Vancouver Scar Scale score was 3(2.25, 3) at 1 month after operation, 1(0.25, 1) at 3 months after operation and 1(0, 1) at 6 months after operation. The differences were statistically significant ( P<0.05). There was a statistically significant difference between 3 months after surgery and 1 month after surgery ( Z=-3.472, P=0.001). There was no statistically significant difference between 6 months after surgery and 3 months after surgery ( Z=-1.414, P=0.157). All patients had no significant postoperative complications such as incision infection, asymmetry of nasal alae, obstruction of nasal ventilation, etc. Postoperative alar and nasal base profiles were significantly improved. Conclusions:Modified alar reduction with external incision can effectively treat alar hypertrophy without obvious postoperative complications. It is a good operation to correct alar hypertrophy.

Botulinum toxin is a potent protein toxin produced by Clostridium botulinum. It acts directly on the brain nerve nucleus and peripheral neuromuscular junction, blocking the release of acetylcholine and thereby affecting nerve impulse transmission, ultimately leading to muscle paralysis. Mild cases may present with ocular muscle involvement, whereas severe cases may involve dysphagia, general paralysis, respiratory depression, and even death. This article reports on a patient who experienced severe poisoning symptoms after using type A botulinum toxin obtained through informal channels. The patient was treated with antitoxin on the 13th day after symptoms onset and achieved a significant improvement in their condition.

Botulinum toxin is a potent protein toxin produced by Clostridium botulinum. It acts directly on the brain nerve nucleus and peripheral neuromuscular junction, blocking the release of acetylcholine and thereby affecting nerve impulse transmission, ultimately leading to muscle paralysis. Mild cases may present with ocular muscle involvement, whereas severe cases may involve dysphagia, general paralysis, respiratory depression, and even death. This article reports on a patient who experienced severe poisoning symptoms after using type A botulinum toxin obtained through informal channels. The patient was treated with antitoxin on the 13th day after symptoms onset and achieved a significant improvement in their condition.