Abstract
The objective of this study was to discuss the technical details and our experiences
with lateral crural tensioning (LCT) in both functional and aesthetic rhinoplasties.
A retrospective medical review was completed for all patients who underwent rhinoplasty
with LCT from the years 2011 to 2014. The indications for LCT included correction
of lateral crural convexity, boxy tip geometry, and dynamic collapse of the external
nasal valve. The details of the rhinoplasty procedure and complications were evaluated.
A total of 114 LCT rhinoplasty cases were included in this series. The most common
adjunctive maneuvers included placement of spreader grafts (92% of cases) and alar
rim grafts (78% of cases). Conventional classic cephalic trim was not performed in
any subjects and conservative paradomal cephalic trim was performed in 48% of cases.
As experience with the technique progressed, the use of onlay tip grafts decreased
and the use of articulated rim grafts increased. Indications for revision were dissatisfaction
with cosmetic outcome (4.4% of cases) and nasal obstruction (0.9% of cases). LCT combines
traditional lateral crural steal with the use of a caudal septal extension graft to
refine the broad tip and increase stability of the alar lobule. This maneuver is essentially
cartilage sparing and does not rely on extensive grafting maneuvers that can reduce
airway area.
Keywords
rhinoplasty - collapse - convexity - tensioning - tip
