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Related Concept Videos

Cephalic Phase of Digestion01:24

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Related Experiment Video

Updated: Feb 12, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?
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Lower Lateral Cartilage Cephalic Malposition: An Over-Diagnosed Entity.

Farhad Hafezi1, Bijan Naghibzadeh2, Abbas Kazemi Ashtiani3

  • 1Plastic Surgery Department, St. Fatima Hospital, Iran University of Medical Sciences and Burn Research Center, Suit 12, No.33, Asef (Ejazi) St., Zaferanieh, Tehran, Iran. fhafezi32@gmail.com.

Aesthetic Plastic Surgery
|April 13, 2018
PubMed
Summary

Nasal lateral wall pinching in rhinoplasty is often not due to cephalic displacement of the lower lateral cartilage (LLC). Severe posterior and lateral crura convexity is the more probable cause, challenging previous assumptions about this common variation.

Keywords:
Bulbous pinchLLC cephalic malpositionNasal tip

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Area of Science:

  • Plastic Surgery
  • Facial Anatomy
  • Rhinoplasty Techniques

Background:

  • Lower lateral cartilage (LLC) malposition, characterized by anterior dome convexity and posterior pinch, is a common finding in rhinoplasty.
  • This variation, often termed
  • bulbous pinch,
  • involves cephalic (upward and inward) rotation of lateral crura, particularly in patients with bulbous nasal tips.
  • Traditionally, cephalic displacement of the LLC is cited as the primary cause, leading to recommendations for caudal repositioning.

Purpose of the Study:

  • To precisely measure the angles of the lateral crura relative to fixed facial reference points.
  • To investigate the anatomical basis of nasal lateral wall pinching in rhinoplasty patients.

Main Methods:

  • Analyzed 40 consecutive rhinoplasty cases, marking lower lateral cartilage (LLC) contours and reference lines.
  • Categorized cases into "bulbous pinch" and "flat LLC" groups.
  • Measured and compared the angles of the right and left lateral crura to the midline and horizontal planes between groups.

Main Results:

  • No statistically significant difference was found in the angles of lower lateral cartilage (LLC) rotation between the "bulbous pinch" and "flat LLC" groups.
  • Measurements included both vertical and horizontal angles of the lateral crura.

Conclusions:

  • Cephalic malposition of the lower lateral cartilage (LLC) is an uncommon variation, despite its reported high frequency.
  • Severe convexity of the posterior and lateral crura, rather than cephalic displacement, is the likely etiology for nasal lateral wall pinching in most cases.
  • Findings suggest a need to re-evaluate the understanding and correction of this nasal deformity in rhinoplasty.