Three-dimensional morphometric analysis of alar asymmetry in unilateral secondary cleft nasal deformity: implications for non-cleft alar reduction in surgical planning.

Preoperative surgical planning for alar reduction remains challenging due to the lack of objective references in traditional measurements. Therefore, this study aimed to objectively quantify preoperative bilateral alar symmetry using 3D best-fit alignment analysis, and to establish an evidence-based threshold for alar morphological deviation for alar reduction in secondary cleft rhinoplasty. 26 patients with unilateral secondary cleft nasal deformity were retrospectively assessed: 13 underwent secondary cleft rhinoplasty alone and 13 received concurrent alar reduction.