Cephalically positioned lower lateral cartilages (LLCs) contribute to the bulbous-appearing nasal tip. Repositioning of the LLCs removes volume created in the nasal sidewall / supratip regions leading to better tip refinement. This reshaping of the tip is ameliorated by application of lateral crural strut grafts, placed on the underside of the LLCs above the vestibular skin. The authors hypothesise that inset of lateral crural strut grafts and repositioning of LLCs will result in a reduction of volume in the area corresponding to the previously cephalically malpositioned LLCs. For measurements the 3dMD system was used to quantify postoperative volumetric changes within the nasal tip complex. Pre- and postoperative images were superimposed to quantify the volumetric differences after surgery. The cephalically malpositioned LLCs were repositioned to an angle of approximately 40° in front view. The above mentioned technique resulted in a volume reduction in the supratip / nasal sidewall junction. Even though changes were clinically meaningful, the results using the 3dMD system did not reach statistical significance. This might be due to the small patient population (n=31), or the limited follow-up time. However, it was obvious that treatment effects were consistent across sexes and that longer follow-ups were associated with a greater decrease in total volume.

Lower lateral cartilage repositioning. Objective analysis using 3-dimensional imaging.
Bared A, Rashan A, Caughlin BP, Toriumi DM.
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Gregor M Bran

Dr Horst Schmidt Kliniken, Wiesbaden, Germany.

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