title: Lower lateral crural turnover flap in open rhinoplasty.
abstract: BACKGROUND
  Lower lateral crural deformities are common problems in rhinoplasty. The shape and position of the lower lateral crura directly influence the alar contour and external valve function. This study reviews an extensive experience with the lower lateral crural turnover flap, which represents a versatile and reproducible technique for correction of lower lateral crural deformities and improvement of external valve function.
  
  
  METHODS
  A retrospective review of our experience with the lateral crural turnover flap in consecutive primary (n = 21), secondary (n = 2), and tertiary (n = 1) open rhinoplasties was conducted to evaluate the indications, contraindications, and long-term outcomes of this technique. Patient case examples are used to illustrate this technique and its results.
  
  
  RESULTS
  The lower lateral crural turnover flap is beneficial for deformities, weakness, and collapse of the lower lateral crura. It can also be used to improve lower lateral crural strength during tip reshaping. It is contraindicated when there is insufficient width of the lower lateral crura. A lower lateral crural turnover flap can complement other external valve and alar arch supporting techniques, such as placement of alar contour grafts and/or alar batten grafts. The shape and position of the lower lateral crural turnover flaps have had long-lasting results (>1 year) after open rhinoplasty.
  
  
  CONCLUSIONS
  The lower lateral crural turnover flap is a useful and reproducible technique in rhinoplasty with enduring results. The use of adjacent cartilage provides a local source of viable tissue to correct and support the lower lateral crura in both primary and revision rhinoplasty.
authors.affiliation: Dallas, Texas From the Department of Plastic Surgery, The University of Texas Southwestern Medical Center.
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Janis
authors.forename: Andrew
authors.initials: A
authors.lastname: Trussler
authors.forename: Ashkan
authors.initials: A
authors.lastname: Ghavami
authors.forename: Vincent
authors.initials: V
authors.lastname: Marin
authors.forename: Rod J
authors.initials: RJ
authors.lastname: Rohrich
authors.forename: Jack P
authors.initials: JP
authors.lastname: Gunter
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D013524:Surgical Flaps; D055815:Young Adult