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IS THE CRANIAL RESECTION OF THE ALAR CARTILAGE IN NASAL TIP SURGERY OLD FASHIONED?


Yves Brühlmann

In every teaching book of rhinoplasty you will find that a cranial resection of the alar cartilage is the best way to refine the nasal tip. Using this method as a standard in every rhinoplasty in my opinion,it is often the wrong way to improve the nasal tip because it will come to a rising of the alar region when one perform the classical cranial longitudinal resection of the alar cartilage. For bulbous or big nasal tip one will think that a big resection will come to a good result after surgery, but this is not correct. A safer way to achieve better result in this problematic nasal tip surgery, is the telescoping method in the middle portion of the lateral crus with only very little or no longitudinal cranial resection of the alar cartilage. In combination you need to correct the dome region with scarification and sutures. This presentation will try to show with some examples that the telescoping method of resection of the alar cartilage is the better way to achieve good result in difficult bulbous or hypertrophic alar cartilage nasal tips.


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