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Updated: Jan 9, 2026

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Advanced Preservation Technique for the Soft Tissue Envelope in Open Approach Rhinoplasty-Cephalic Lateral Crus,

Daniel Ben Ner1,2, Adi Busel1,2, Alwyn D'Souza3

  • 1Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.

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Summary

This study introduces the cephalic lateral crus-scroll-Pitanguy (CLC-SP) flap technique for open rhinoplasty. It preserves the soft tissue envelope, improving nasal breathing and aesthetics while preventing deformities.

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Area of Science:

  • Plastic Surgery
  • Facial Reconstructive Surgery
  • Nasal Anatomy

Background:

  • Open rhinoplasty often disrupts the soft tissue envelope, risking deformities like pollybeak and nasal valve collapse.
  • Traditional reconstruction methods contrast with a preservation philosophy for soft tissues.
  • Thick skin presents unique challenges in rhinoplasty outcomes.

Purpose of the Study:

  • To present the cephalic lateral crus-scroll-Pitanguy (CLC-SP) flap technique for preserving the soft tissue envelope during open rhinoplasty.
  • To evaluate the efficacy of the CLC-SP flap in preventing adverse outcomes in patients with thick skin.
  • To assess functional and aesthetic improvements following the CLC-SP flap procedure.

Main Methods:

  • Retrospective analysis of 22 patients with thick skin undergoing open rhinoplasty.
  • Dissection preserving the cephalic lateral crus (LC) with its soft tissue attachments as a composite flap (CLC-SP flap).
  • Evaluation of nasal breathing, aesthetic satisfaction, and occurrence of pollybeak deformity post-surgery.

Main Results:

  • Nineteen patients reported improved nasal breathing; 21 reported aesthetic satisfaction after a mean 5.4-month follow-up.
  • No instances of pollybeak deformity were observed in the study cohort.
  • The CLC-SP flap technique effectively controlled tip definition, supported the nasal valve, and minimized dead space.

Conclusions:

  • The CLC-SP flap is an effective technique for preserving the soft tissue envelope in open rhinoplasty for thick-skinned patients.
  • This method aids in preventing pollybeak deformity and nasal valve collapse.
  • The technique enhances tip definition and functional outcomes, supporting anatomical restoration.