title: Use of the upper lateral cartilage sagittal rotation flap in nasal dorsum reduction and augmentation.
abstract: BACKGROUND
  Medial rotation flaps of the upper lateral cartilages are useful in nasal dorsum reduction surgery because they maintain the separation between the upper lateral cartilages and the septum, and usually avoid the need for spreader grafts. These flaps, however, can be technically challenging. Sagittal rotation flaps of the upper lateral cartilages are more flexible and simpler to apply in nasal dorsum reduction surgery. These flaps can also be utilized in nasal dorsum augmentation surgery.
  
  
  METHODS
  Seventy-one patients underwent dorsal reduction surgery utilizing a posteroinferior sagittal rotation of the upper lateral cartilages. In one-third of patients, in whom there was significant cartilage excess, the sagittal rotation was supplemented with a simplified and incremental medial rotation. Dorsal augmentation with anterosuperior sagittal rotation of the upper lateral cartilages was performed in 11 patients with select caudal dorsal deficiencies.
  
  
  RESULTS
  The use of a sagittal rotation simplified the upper lateral cartilage flap procedure in dorsal reductions and significantly reduced the need for medial rotations. The technique was intuitive and could be applied to minor and major dorsal reductions. In select dorsal augmentations, the flap helped avoid the need for potentially visible onlay grafts.
  
  
  CONCLUSIONS
  Sagittal rotation of the upper lateral cartilages helps preserve the normal anatomy of the upper laterals and the important relationship between the upper laterals and the septum.
authors.affiliation: Toronto, Ontario, Canada From the Division of Plastic Surgery, North York General Hospital, Toronto, Canada, in association with the University of Toronto.
authors.forename: Bernd R
authors.initials: BR
authors.lastname: Neu