An Alternative Rhinoplasty Technique: Rotational Spreader Flap ("Rabbit Flap")

Area of Science:

• Plastic Surgery
• Otolaryngology
• Facial Plastic Surgery

Background:

• Septal cartilage is the primary graft material in rhinoplasty.
• Insufficient septal cartilage presents a significant challenge in reconstructive surgery.
• The rabbit flap is introduced as an alternative graft source.

Purpose of the Study:

• To evaluate the effectiveness of the rabbit flap technique.
• To assess improvements in nasolabial angle, nasal axis deviation, and nasal dorsal line.
• To determine the suitability of the rabbit flap as an alternative to septal cartilage.

Main Methods:

• The rabbit flap is created from the cephalic portion of the lower lateral cartilage (LLC).
• The technique preserves the connection between the lateral and medial crus of the alar cartilage.
• The flap is positioned to provide a spreader graft effect and adjust nasal tip rotation.
• Objective measurements of nasal axis and nasolabial angles and subjective patient questionnaires (ROE) were used for evaluation.

Main Results:

• Significant improvements were observed in ROE scores, nasal axis deviation, and nasolabial angles.
• Preoperative and postoperative first-year comparisons showed statistically significant positive outcomes (p < 0.001).
• No complications were reported during the study period.

Conclusions:

• The rabbit flap technique effectively corrects nasal tip rotation and mild nasal axis deviation.
• It helps achieve a proper nasal dorsal line, prevents inverted V deformity, and expands the internal nasal valve.
• The technique is a viable alternative in rhinoplasty, provided the LLC is sufficiently strong to prevent alar collapse.