Barrel roll technique for the correction of long and concave lateral crura

To describe the barrel roll technique that is capable of concurrently correcting 2 associated deformities--overprojection and ptosis of the nasal tip.

Thirty-two patients with concavity of the upper section of 1 or both lateral crura combined with a droopy tip were treated from January 1, 2005, through December 31, 2007. In all cases, the barrel roll technique was used, which involves rotating the lateral crus by 180° on its major axis so that the concavity is transformed into convexity, and carrying out lateral crural overlay to correct the overprojection concurrently.

All the patients displayed functional and aesthetic improvement by correcting the droopy tip and concavity of the lateral crura. Revision was necessary in 1 case of monolateral concavity. The comparison of preoperative and postoperative rhinomanometric data showed significant improvement of nasal airway resistance.

A combination of the overlay technique and rotation of a portion of the lateral crus on its axis is capable of concurrently correcting serious functional problems and aesthetic defects of the nasal tip. The open approach is essential for perfect positioning of the mobilized cartilaginous segments and ensuring stable results over time.