Lateral Crural Mid-Down Flap Technique in Primary Rhinoplasty

Nasal tip surgery, especially the correction of deformities of the lateral crura, is perhaps one of the most difficult areas of rhinoplasty, and many different techniques have been described in the literature.

The authors describe a new flap technique for the correction of excessive convexity of lateral crura causing boxy, bulbous, and parentheses tip deformities.

Thirty patients were randomly divided into two groups with equal numbers of male and female patients in each group. In half of the patients, lateral crural correction was performed with the cephalic excision (CE) method, while in the other half, it was performed with the lateral crural mid-down flap (LCMF) technique described by the authors. SCHNOS (standardized cosmetic and health nose outcomes questionnaire), nasal pinching questionnaire, and VAS (visual analog scale) were used to evaluate the results within and between groups.

While significant improvement was observed in both techniques according to SCHNOS and VAS compared to preoperative evaluation, no significant difference was observed between the two groups. On the other hand, in the nasal pinching questionnaire, which includes more specific questions about the nasal tip aesthetics and nasal valve function, better postoperative results were obtained in the LCMF technique, while deterioration was observed in the CE technique according to preoperative findings.

The LCMF technique can be considered as an easy and suitable technique for the correction of lateral crura, especially in patients with excessively convex lateral crura with a bulbous nasal tip.

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