Alar batten grafts are grafts used to fortify the nasal airway and prevent collapse. The name alar batten comes from the word alar (which is part of the nasal ala) and batten (which means is a nautical term meant ascribed to a sail to stiffen). More recently they have been used to prevent alar retraction and improve the pinched look seen in many postoperative rhinoplasty patients.
Alar batten grafts are typically placed in pockets just superior to the lower lateral cartilages. This is seen as an supraalar crease on photographs. The grafts are placed in a subcutaneous pocket. Alar batten grafts can also be placed inferior to the lower lateral cartilage when the cartilages are cephalically positioned. In this context, however, the lower lateral cartilage may also be repositioned to an improved location.
Alar batten grafts can be made up of septal, costal, or conchal cartilage. However, conchal cartilage or ear cartilage, is often soft and has less strength, making it a less than ideal choice for patients with significant collapse.
Postoperatively, patients will have fullness to their supraalar region. Depending on the patient, this fullness may take 6 months or more to resolve. Patients most likely to be dissatisfied with this are patients who did not have alar collapse prior to surgery. They should be told that this is temporary. Grafts used for that purpose are typically smaller.
The goal of alar batten grafts is to prevent collapse of the ala and support the nose where no cartilage exists. It also hopes to serve as a filler to prevent alar retraction.
“The nose should fit the face”
A strong jawline would suggest a stronger nose.