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Updated: Jan 11, 2026
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Central Platform Surgery for Large and Deviated Noses-The Libra Flap: Low Septal Strip Dorsal Y Preservation
Background:
Traditionally, dorsal reconstruction is required after osseocartilagenous resection in patients with large noses where the cartilaginous dorsum is overdeveloped and wide, rendering preservation impossible. Reducing the need for dorsal reconstruction by changing the resection technique in such noses would be advantageous.
Objectives:
The aim of this study was to describe and evaluate a technique for the anatomic resection of the nasal dorsum that can be used in those patients who fall in the gray area between requiring traditional dorsal preservation and structural techniques. Dorsal Y preservation precuts the intended dorsal aesthetic lines, creating a central platform that can be flexed, lowered, or moved laterally.
Methods:
Seventy-seven patients who underwent low septal strip dorsal Y preservation by 2 different surgeons were studied retrospectively.
Results:
Of the 77 patients, 85.7% (66) were female and 14.3% (11) were male. A closed approach was used in all cases. The patients were followed up from 6 to 36 months with a median follow-up of 13 months.
Conclusions:
The central platform (Libra flap) technique provides anatomical results in patients with large, wide noses and an axis deviation. For those cases with other challenges, dorsal preservation and structure techniques should remain as preferred treatment modalities.
Level Of Evidence: 4:
(Therapeutic) For image description, please refer to the figure legend and surrounding text.
