scholarly journals The Stabilization of Lower Lateral Cartilage in Rhinoplasty: A New Control Suture Technique.

2020 ◽  
pp. 1-6

Abstract Objective: Reposition of malpositioned lateral crura to normal position in rhinoplasty is important both functionally and aesthetically. The aim of this study is to describe a lateral cruras reposition suture technique for supplying tip symmetry and avoiding crural displacement. Patient and Method: Sixteen primary rhinoplasty cases with malpositioned lateral crura underwent lateral crural control suture (LCCS) were reported. In this technique dissected and released lateral crura were fixed to cheek skin with a suture. Those cases were assessed with FACE-Q rhinology module both aesthetically and functionally. Result: Intraoperative or postoperative lateral crural displacement can be prevented and nasal tip symmetry can be supplied easily with LCCS. Results were satisfactory both functionally and aesthetically. Conclusion: LCCS is a good alternative to correct lateral crural malposition and obtain a tip symmetry.

2012 ◽  
Vol 16 (02) ◽  
pp. 232-235
Author(s):  
Marcos Mocelin ◽  
Caio Soares ◽  
Rogério Pasinato ◽  
Andreia Frota ◽  
Cezar Berger

Summary Introduction: Several techniques can be performed to improve nasal tip definition such as cartilage resection, tip grafts, or sutures. Objctive: To evaluate the outcome of lateral intercrural suture at the lower lateral cartilage by endonasal rhinoplasty with a basic technique without delivery in decreasing the angle of domal divergence and improving the nasal tip definition. Method: This prospective study was performed in 64 patients in which a suture was made on the board head of the lower lateral cartilage in the joint between the dome and lateral crus, using polydioxanone (PDS) with sharp, curved needle. Results: In all of the cases, better definition of the nasal tip was achieved by intercrural suturing for at least 6 months postoperatively. Conclusion: Lateral intercrural suture of the lower lateral cartilage provides improved nasal tip definition and can be performed by endonasal rhinoplasty without delivery in the Caucasian nose.


1994 ◽  
Vol 111 (3P1) ◽  
pp. 219-231 ◽  
Author(s):  
Peter A. Adamson ◽  
Todd A. Morrow

It is generally agreed that rhinoplasty is the most challenging procedure performed by the facial plastic surgeon. Mastery of nasal tip maneuvers to alter tip projection, rotation, and lobule refinement is intrinsic to successful rhinoplasty technique. The nasal hinge region comprises the most lateral aspect of the lower lateral cartilage. Its importance is often overlooked. As the foundation of the nasal base, It plays a key role in tip dynamics and can be sculpted to significantly modify projection, rotation, and lobule refinement. One hundred randomly selected rhinoplasty patients were studied with respect to the indications for hinge maneuvers, techniques applied, and resulting affect on tip aesthetics. Clinical results are shown. The applicability of these hinge techniques is compared with other lateral crural techniques. The importance of the hinge region in rhinoplasty dynamics and the necessity of knowledgeably applying surgical maneuvers in this region are discussed.


1985 ◽  
Vol 93 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Frank M. Kamer ◽  
Alfred Cohen

One of the most difficult problems encountered in rhinoplasty is lack of nasal tip projection. An innovative technique is described that utilizes the removal of a median horizontal strip of lower lateral cartilage to enhance projection, while maintaining a natural highlight and tip support without the use of grafts. The indications are limited to noses that have a widened dome requiring removal of a central strip, and tip rotation. Alternate techniques are discussed; cases and results are discussed.


Author(s):  
Tito M. Marianetti ◽  
Valentino Vellone ◽  
Valerio Ramieri ◽  
Francesca De Angelis

Abstract Background To present a novel approach to correct nasal tip deviation with monolateral crural overlay or monolateral dome truncation, presenting as an isolated deformity or in complex nose deviations. Nasal tip deviation can be congenital or posttraumatic, due to a dislocated septum or cartilaginous septal or lower lateral cartilage malformations. Although some treatment strategies have been introduced, appropriate treatment remains a challenge because of the complexity and variability of such deformities. Methods It had been assumed that in most nasal tip deviations, a lower lateral cartilage was longer than the contralateral one. The authors analyzed 158 patients from January 2015 to October 2019 with nasal tip deviation and corrected the deviated tip by using a monolateral interruptive technique (lateral crural overlay or monolateral dome truncation) on the lower lateral cartilage. Photographic comparison between preoperative and at least 1-year follow-up for nasal axis deviation variable was analyzed and a self-assessment questionnaire was administrated to the patients at 1-year follow-up. Results The mean nasal deviation was 6.59° (±3.1°) preoperatively and 1.56° (±0.26°) postoperatively (p < 0.05). The range of differences between pre and postoperative deviations was 2.7° to 15.1°, and the mean difference was 6.1° (±3.21°). Of the 84 patients, 47 (55.95%) were very satisfied, 33 (39.28%) were satisfied, and 4 (4.76%) were unsatisfied with surgical the results and required revision surgery. Conclusions In authors' hands, monolateral interruptive techniques (lateral crural overlay or monolateral dome truncation) are a viable and feasible option to restore nasal tip symmetry. These techniques achieved high satisfaction rates among patients and resulted in reliable and reproducible symmetry immediately visible after surgery and stable over time (1-year postsurgery controls).


1998 ◽  
Vol 15 (2) ◽  
pp. 137-141
Author(s):  
Steven Burres

Most of the reshaping techniques for a blunt, bulbous nasal tip reduce the curvature and surface area of tip lobule cartilage, and they reform the tip to add definition. Unfortunately, the assemblage of surgical maneuvers frequently reduces valued projection, and it may result in an unnatural tip formation with a distasteful pattern of contracture. Employing the Isis cruraplasty allows incremental tip enhancement and narrowing, while restoring or preserving the natural configuration. After lateral dome division and undermining of the medial portion of the lateral crus, the lateral segment of the lateral crus was transected incrementally and advanced to reenforce the deficiency in rim support. Sewing the medial flanges together created a cartilaginous platform that supported the Isis graft, and/or it accommodated a columellar strut, if indicated. The Isis cruraplasty conserves virtually all of the lower lateral cartilage without compromising the potential for tip reshaping and augmentation.


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