Effect of midfacial asymmetry on nasal axis deviation: indications for use of the subalar graft.

OBJECTIVE To test the hypothesis that midfacial asymmetry specifically relevant to nasal tip deviation will be reflected in the measured soft-tissue attachments of the ala to the face. DESIGN Retrospective photographic analysis of 35 consecutive patients seeking functional or aesthetic nasal surgery regardless of cause. RESULTS Nasal axis had a significant correlation with the alar-facial angle on base view photographs (P < .001) irrespective of cause (traumatic vs congenital). However, there was no significant correlation between alar facial angle on anteroposterior view (frontal) with nasal axis and no correlation between frontal and basal angles. CONCLUSION Soft-tissue analysis demonstrates a relationship between nasal axis deviation and lower midfacial asymmetry or hypoplasia.