[Esthetic surgery of large nasal tips. Contribution of the "flying wing" procedure]

The "flying wing" procedure has been known for a long time. It is classically used in the treatment of moderately severe saddle nose. The author proposes the use of this technique for the aesthetic correction of certain flattened nasal tips. Technically, the original procedure is modified by: a transcartilaginous rather than marginal approach, partial rather than total transfer of the lateral crus to preserve the alar ring, resection as required at the junction of the two crura to allow transposition without deformation of the nostril aperture, the possible association with suture-approximation of the domes in order to accentuate the projection of the nasal tip. This procedure may be indicated in secondary, dysmorphic or simply unsightly fattened tips whenever the preoperative assessment reveals a low profile of the nasal spine with osteocartilaginous disjunction, even minor, associated with flattening of the tip, simultaneously resulting in: the need for reinclusion for harmonization of the profile and the need to shorten elevate and reduce the tip. Application of this technique to a limited series (11 cases) does not eliminate any other procedures, particularly reinclusions; the principle of the "flying wing" adapted in this way and respecting the continuity of the two arches of the alar cartilage, is nevertheless attractive.