Graft-Free Lateral Crural Rotation for External Nasal Valve Collapse and Nasal Tip Refinement: A Cartilage-Preserving...

External nasal valve collapse frequently coexists with nasal tip aesthetic deformities. Conventional correction relies on structural grafting, which may increase operative time, donor-site morbidity, and tip rigidity. We describe a cartilage-preserving, graft-free technique designed to restore external nasal valve competence and refine nasal tip definition.

A retrospective clinical series of 30 patients with external nasal valve collapse who underwent graft-free lateral crural rotation between 2022 and 2025 was performed. Patients with a minimum follow-up of 6 months were included. The technique involves mobilization of the lateral crus and its insertion into a subdermal alar pocket without the use of additional cartilage grafts. Outcomes were assessed using physical examination, standardized photographic analysis evaluated by 2 independent observers, and the Rhinoplasty Outcome Evaluation (ROE) questionnaire at 6 months.

The technique restored external nasal valve stability on physical examination and improved nasal tip contour on photographic analysis. Observer-based evaluation demonstrated consistent aesthetic improvement. Patients reported improvement in nasal airflow and high satisfaction based on ROE scores. No major complications were observed during the follow-up period.

Graft-free lateral crural rotation is a cartilage-preserving technique that may improve external nasal valve support and nasal tip aesthetics while minimizing operative complexity and donor-site morbidity. These preliminary findings suggest favorable functional and aesthetic outcomes; however, further prospective studies with objective functional assessment are required.