Download PDF
Facial Plast Surg 2016; 32(01): 049-058
DOI: 10.1055/s-0035-1570504
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Form and Function of the Nasal Tip: Reorienting and Reshaping the Lateral Crus

Grant S. Hamilton III
1   Division of Facial Plastic Surgery, Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota
› Author Affiliations
Further Information

Publication History

Publication Date:
10 February 2016 (online)

    Permissions and Reprints

Abstract

Dysfunction of the external nasal valve affects both the form and function of the nose. Successful treatment of these problems is dependent on proper analysis and diagnosis of the aberrant anatomy. Cephalic malpositioning of the lateral crura has been described for nearly 30 years. Repositioning of the lateral crura in a more caudal orientation with lateral crural strut grafts will correct aesthetic abnormalities and reinforce the external nasal valve. Sagittal malpositioning has been more recently described and also has deleterious effects on both the shape of the nasal tip and breathing. Reorienting the short axis of the lateral crus is another powerful tool for the rhinoplasty surgeon to correct the weak and narrow external nasal valve.

Keywords

rhinoplasty - external nasal valve - cephalically malpositioned lateral crura - sagittally malpositioned lateral crura - nasal obstruction
 

  • References

  • 1 Fomon S. Cosmetic Surgery—Principles and Practice. Philadelphia, PA: Lippincott; 1960
    Google Scholar
  • 2 Goldstein J, Davidoff J, Roberson D. Knowing color terms enhances recognition: further evidence from English and Himba. J Exp Child Psychol 2009; 102 (2) 219-238
    CrossrefPubMedGoogle Scholar
  • 3 Winawer J, Witthoft N, Frank MC, Wu L, Wade AR, Boroditsky L. Russian blues reveal effects of language on color discrimination. Proc Natl Acad Sci U S A 2007; 104 (19) 7780-7785
    CrossrefPubMedGoogle Scholar
  • 4 Simons DJ, Chabris CF. Gorillas in our midst: sustained inattentional blindness for dynamic events. Perception 1999; 28 (9) 1059-1074
    CrossrefPubMedGoogle Scholar
  • 5 Sheen J. Aesthetic Rhinoplasty. 2nd ed. St Louis, MO: CV Mosby; 1987
    Google Scholar
  • 6 Daniel RK. The nasal tip: anatomy and aesthetics. Plast Reconstr Surg 1992; 89 (2) 216-224
    CrossrefPubMedGoogle Scholar
  • 7 Toriumi DM. New concepts in nasal tip contouring. Arch Facial Plast Surg 2006; 8 (3) 156-185
    CrossrefPubMedGoogle Scholar
  • 8 Constantian MB. The boxy nasal tip, the ball tip, and alar cartilage malposition: variations on a theme—a study in 200 consecutive primary and secondary rhinoplasty patients. Plast Reconstr Surg 2005; 116 (1) 268-281
    CrossrefPubMedGoogle Scholar
  • 9 Sepehr A, Alexander AJ, Chauhan N, Chan H, Adamson PA. Cephalic positioning of the lateral crura: implications for nasal tip-plasty. Arch Facial Plast Surg 2010; 12 (6) 379-384
    CrossrefPubMedGoogle Scholar
  • 10 Hamra ST. Repositioning the lateral alar crus. Plast Reconstr Surg 1993; 92 (7) 1244-1253
    PubMedGoogle Scholar
  • 11 Rochira D, Ottaviani A. Malposition of alar cartilages: a personal modification of the Sheen technique. Plast Reconstr Surg 2008; 122 (2) 72e-73e
    CrossrefPubMedGoogle Scholar
  • 12 Toriumi DM, Asher SA. Lateral crural repositioning for treatment of cephalic malposition. Facial Plast Surg Clin North Am 2015; 23 (1) 55-71
    CrossrefPubMedGoogle Scholar
  • 13 Hamilton III GS. Correction of sagittally malpositioned lateral crura. Ear Nose Throat J 2009; 88 (6) 961-962
    PubMedGoogle Scholar
  • 14 Palesy T, Pratt E, Mrad N, Marcells GN, Harvey RJ. Airflow and patient-perceived improvement following rhinoplastic correction of external nasal valve dysfunction. JAMA Facial Plast Surg 2015; 17 (2) 131-136
    CrossrefPubMedGoogle Scholar