Facial plast Surg 2017; 33(05): 483-490
DOI: 10.1055/s-0037-1606638
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Management of the Cephalically Malpositioned Lower Lateral Crus in Aesthetic Rhinoplasty

Milos Kovacevic1, Oren Friedman2, Frank Riedel3, 4, Jochen Wurm5, Gregor M. Bran3, 4
  • 1HNO-Praxis Am Hanse-Viertel, Hamburg, Germany
  • 2Department of Otorhinolaryngology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
  • 3HNO-Zentrum Rhein-Neckar, Mannheim, Germany
  • 4Department of Otorhinolaryngology, Head and Neck Surgery, Universitatsklinikum Mannheim, Mannheim, Baden-Württemberg, Germany
  • 5Department of Otolaryngology, Head and Neck Surgery, University Erlangen-Nuremberg, Erlangen, Germany
Weitere Informationen


29.September 2017 (online)


Cephalic malposition of the lower lateral cartilages (LLC) gained increasing awareness as a distinct anatomical entity within the last years. It has become clear that this type of deformity is not amenable to traditional rhinoplasty techniques. Repositioning of the lateral crus of the LLC enables the surgeon to achieve significant and reliable changes in the shape and function of the nose. The authors present their technique for repositioning of the cephalically malpositioned LLC. Their method is based on a turn-in flap that is positioned along the caudal margin of the repositioned LLC. This flap straightens a convex LLC and gives reliable structural support to the caudal alar margin. In this article, they discuss the various indications of this technique, introduce a new, more precise concept for evaluation of the axis of the lateral crus of the LLC, and highlight additional details of this reliable technique.