Lateral crus sculpturing in open rhinoplasty: the Delicate Alar Clamp

The wide exposition obtained with the open approach in rhinoplasty allows a precise evaluation of size, morphology, thickness, and position of the alar cartilages. This precise intraoperative diagnosis has permitted the development and improvement of surgical techniques in nasal tip sculpturing. At the same time, many surgical instruments have been adapted or created for the external approach. We describe our preferred and most commonly selected sequence in primary rhinoplasty with emphasis on the nasal tip work. A new, personally developed instrument, named the Delicate Alar Clamp, utilized to hold and stabilize the lateral crus during measurement and sculpturing of the cartilage, is presented with the description of its technical characteristics and practical application.