Reinforcement of Lower Lateral Cartilage Using Sliced Costal Periphery to Reconfigure Nasal Tip in Asian Rhinoplasty

Background: Reinforcement of lower lateral crura (LLC) is an imperative prophylaxis against the secondary deformity of alar and nasal tip in Asian rhinoplasty. The common limitation of the existing techniques is loss of nasal tip's mobility to a large degree in exchange for structural stability. In search for a natural and animated postoperative nasal tip, the elasticity and rigidity of coastal periphery was taken into account. Method: Two pieces of sliced costal periphery (SCP) were used to reinforce the LLC. One hundred twenty patients who accepted this technique and completed 18-month follow-up were included in this study. They were all females in which 67 patients underwent the primary rhinoplasty, and the remaining 53 patients underwent the revision rhinoplasty. Two pieces of septal extension grafts and 2 strips of SCP were used in all patients. Videos and pictures were taken and analyzed preoperatively and at 18 months postoperatively. Result: The videos and pictures showed the pleasing contour and mobility of nasal tip. No complications associated with the LLC occurred. All patients who underwent primary rhinoplasty were pleased about the postoperative contour and mobility of nasal tip. In revision rhinoplasty group, 30 patients (56.6%) who had complained about the stiffness or mobility loss of the nasal tip before became satisfied with the soft and animated nasal tip after the surgery. Conclusion: Reinforcement of LLC by SCP is a promising technique to achieve natural and animated nasal tip. Moreover, this technique is helpful to prevent or restore the problems associated with the inherent weak or iatrogenic cripple of LLC in Asians rhinoplasty. Studies with longer follow-up and larger sample should be done to trace the reliability and practicability in the long run. Address correspondence and reprint requests to Baokai Li, MD, Shanghai Mylike Medical Cosmetic Hospital, 789 West Yanan Road, Changning District, Shanghai, China; E-mail: 458649766@qq.com Received 2 November, 2017 Accepted 11 February, 2018 YN, HZ, and BL contributed equally to this paper. The authors report no conflicts of interest. Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (https://ift.tt/2iuFjMi). © 2018 by Mutaz B. Habal, MD.

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