Lateral Crural Setback With Cephalic Turn-in Flap

Abstract

Herein, I describe lateral crural setback with cephalic turn-in flap as a new technique for management of the drooping nose. I report a technique for reinforcement of the alar cartilage after partial removal of its caudal portion used in 23 patients during open rhinoplasty. An objective assessment, which included measurement of nasal tip rotation and projection, was applied preoperatively and postoperatively. The average follow-up period was 11 months. Satisfactory results were achieved that resulted in an increase in the degree of nasal tip rotation. The mean increase of the nasolabial angle was 12°. This technique allows increasing the nasal tip rotation in an incremental fashion with preservation of nasal valve function and the strength and stability of the tip complex.

Turn-in Flap: 10 Years’ Experience of a Single Institution in Saudi Arabia

“…Our population was made up of 35% males and 65% of females with a mean age of 23 years. This is comparable to the previous reports [2,3,20,24]. Our population was followed up for a mean duration of two years (one to 10 years).…”

“…The Turn-in flap is a non-destructive, incremental, and reversible procedure carried out during rhinoplasty and it has been proven effective in correcting excessively convex and concave LLC with horizontal mattress sutures with no need for further grafting material [2,3,24].…”

“…Afterward, Murakami et al reported similar technique in 2009 on 18 patients to strengthen the alar cartilage after cephalic trimming [2,3]. In 2010, Sazgar used the same technique during the management of 23 cases of the drooping nose during open rhinoplasty [24]. In 2012, Apaydin modified the Turn-in flap procedure to reshape and add structure to the LLC to suspend the internal nasal valve in 24 patients [20].…”

Lateral crural overlay of the lower lateral cartilages, a technique to enhance nasal tip rotation, and reduce projection in the droopy nasal tip

“…It is relatively uncommon to need further deprojection than can be accomplished with MCO or LCO alone. 1,5 Many surgical technics, 5 have been described for reducing the projection of the tip of the nose, including but not limited to, the medial sliding technic, 6 overlapping of the lateral crus of the lower lateral cartilages, [1][2][3] alar setback, 7 Lateral Crural Setback With Cephalic Turn-in Flap, 8 Hockey stick Nasal Dome Division, 9 , Nasal Base, Alar Base Excision Technique, 10 Intermediate Crural Overlay, 11 Modified Vertical Dome Division Technique, 12 the lateral crural stairstep technique, 13 and many others. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Michael et al…”

Preservation of the Nasal Valve Area With a Lateral Crural Hinged Flap: A Cadaveric Study

“…The authors of this article have introduced new techniques for tip plasty that involve creating a hinged flap of LC and preserving LLC continuity [9,11,12]. With these…”