The role of the upper lateral cartilages in aesthetic rhinoplasty.
BACKGROUND
Reducing lateral nasal tip width in order to optimize shape while still maintaining function presents a challenge to the operating surgeon. Techniques for the reduction of tip width are typically limited to resection, plication, or medial augmentation of the lower lateral cartilages (LLC).


OBJECTIVE
This study describes a reduction of both the length and width of the lateral half of the upper lateral cartilages (ULC) to effect a change in nasal tip shape in selected individuals.


METHODS
Between January 2003 and February 2005, we reviewed the records of 217 patients undergoing primary rhinoplasty; of these, 43 patients underwent partial resection of the ULC to alter nasal tip shape. In this selected group of patients, resection of a portion of the ULC infralaterally was performed, along with partial resection of the LLC.


RESULTS
No patients noted increased difficulty breathing postoperatively, so nasal valve function was maintained. Reduction of superior lateral tip width was observed in all patients.


CONCLUSIONS
Judicious modification of the lateral portion of the ULC--taking care to maintain adequate length and breadth of the medial portion of the cartilage in selected individuals--results in significant improvement in nasal tip width. A specific subset of our patients, approximately 20%, benefited from this approach. Conservative resection of the ULC can enhance nasal tip shape. While clearly not applicable in the majority of patients, the described technique represents a useful addition to the algorithm we may employ in determining the surgical approach in patients seeking aesthetic rhinoplasty.
Pensler
Jay M
JM
Northwestern University Feinberg School of Medicine, Chicago, IL, USA. jpensler@aol.com
D000328:Adult; D000465:Algorithms; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D055171:Nasal Cartilages / Q000601:surgery*; D018579:Patient Selection; D012225:Rhinoplasty / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult