Two-dimensional shape and dimensions of lower lateral alar cartilages (LLCs) for corrective rhinoplasty

Total LLC reconstruction always poses a challenge for plastic surgeons. Various techniques have been used to reconstruct destructed LLC, but there is still a lack of information regarding their morphology. Our objective is to obtain dimensions and configurations of flattened cadaveric LLCs. This information will help plastic surgeons design a reconstructed LLC from a slice of costal cartilage, then fold it into a three-dimensional (3D) shape resembling the native LLC of the patient.

Forty LLCs from 20 fresh cadavers were retrieved. LLCs were gently compressed in an anteroposterior direction using microscopic slides. Each LLC's two-dimensional (2D) configuration was photographed with scale and then measured using ImageJ software. All 2D shapes were analyzed to find a common pattern. LLC templates were created, with size adjustments regarding the gathered data.

The age of cadavers was 38 to 77 years (mean 56.15 years). There were 17 males and 3 females. Cadavers were Asian (95%) and Caucasian (5%). Dimensions of flattened LLC and LLC common shapes resulting from different common pixel thresholds are shown. The shapes of the LLC 2D templates were created from the LLC's common pixel threshold at 25, as it resembles the shape of a native LLC.

Our study provides cadaveric LLC data that can be applied in total or near-total LLC reconstruction. To our knowledge, this is the first study that provides the 2D shape and dimensions of LLCs and 2D LLC templates, which we found very helpful in nasal reconstruction.