The postoperative increase in interalar rim width was measured in two groups undergoing Le Fort I impaction or advancement. In the control group, 19 patient with a conventional osteotomy, an absorbable alar cinch suture, and V-Y closure were followed for 20 months on average. In the experimental group, 12 patients with a subspinal Le Fort I osteotomy (without alar cinch or V-Y closure) were followed for 15 months on average. Interalar rim width was measured with a slide gauge preoperatively, at several times during surgery, and at the 6-month and late follow-up appointments. At surgery, the alar cinch suture decreased the interalar rim width by 50% in the control group. Still, after extubation, there was no statistical difference between groups. At the 6-month follow-up measurement, the interalar rim width was significantly (1.92 mm) smaller in the subspinal group. At the late follow-u p, this difference had decreased by a mean of 0.61 mm.