Repositioning the lateral alar crus

Area of Science:

• Plastic Surgery
• Otolaryngology
• Facial Anatomy

Background:

• Malposition of the lateral crus is a normal variant of nasal alar cartilage, often presenting as a "parentheses" deformity.
• Cephalic positioning of the lateral crus results in inadequate cartilaginous support of the alar rims, leading to cosmetic deformities and potential airway compromise.

Purpose of the Study:

• To describe a modified Sheen technique for correcting lateral crus malposition.
• To demonstrate the efficacy of this technique in improving nasal tip projection and alar dome symmetry.
• To highlight the technique's value in addressing an often-overlooked anatomic variant in rhinoplasty.

Main Methods:

• A modification of the Sheen technique for lateral crus malposition is presented.
• The procedure can be performed via either an open or a closed rhinoplasty approach.
• Key steps involve addressing the overprojecting nasal tip and widening the lateral crus divergence angle.

Main Results:

• The modified technique effectively decreases overprojection of the nasal tip.
• It preserves the equal height of the alar domes, enhancing symmetry.
• The procedure widens the angle of divergence of the lateral crus, improving nasal form.

Conclusions:

• This modified Sheen technique offers a dependable solution for lateral crus malposition.
• It addresses both aesthetic deformities and potential airway issues associated with this variant.
• The technique is a valuable addition to the rhinoplasty surgeon's armamentarium for managing this common anomaly.