Flaring of the nostrils is a common side-effect of a maxillary osteotomy. At times flaring is minimal or of no significance. In some instances, it can be a significant postoperative concern to the patient, even to the extent of declining maxillary surgery. The cinch suture has had conflicting evidence for its long-term benefit of preventing this flaring. This paper from London suggests that the suture can produce relative stability at three years, reducing the unwanted alar base width changes. Of 77 patients who had a cinch suture placed and attended for a long-term follow-up over three years, relapse was found to be less than 1mm in the two parameters measured. It may be worth following this, certainly in the cases where the untoward changes would be a significant concern to the patient (or operator). This is a technique that should be adopted regularly. 

Long-term stability of limiting nasal alar base width changes with a cinch suture following a Le Fort I osteotomy and submental intubation
Raithatha R, Naini FB, Patel S, Sherriff M, Witherow H.
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Stuart Clark

Manchester Royal Infirmary, Manchester, UK.

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