A Strong and Elegant Sidewall: What to do with the Upper and Lower Lateral Cartilage Deformities
LEVEL
A – Introductory
B – Comprehensive
C – Advanced
CONTENTS
The nasal sidewalls constitute the nasal dorsal aesthetic lines. At the time of the primary rhinoplasty, as we modify the dorsal anatomy of the upper lateral-dorsal septum junction, inherent structural problems of the upper lateral cartilages present a new set of issues to deal with. As upper lateral cartilage infolding techniques are more routinely used, we have to acknowledge the subtle differences in the anatomy. Unfortunately, these different presentations are all intra operative findings and the surgeon should be well equipped to modify the surgical approach, accordingly.
The lower lateral cartilages form the cartilaginous framework for the caudal portion of the lateral wall. Depending on the orientation, angulation and thickness of the lower lateral cartilages, various surgical approaches are possible. The proximity of the LLC to the skin make it possible to determine the anatomical variations preoperatively, however a rhinoplasty surgeon should be familiar with the surface topography.
OBJECTIVES
- Assessment of upper lateral cartilage thickness, asymmetry and length
- Decision making in the technique selection for reconstruction of the nasal dorsal aesthetic lines
- Techniques to deal with the upper lateral cartilage asymmetries
- How to read the tip surface topography
- Increase awareness for the cephalic orientation of the lower lateral cartilages