title: Horizontal reduction using a cephalic hinged flap of the lateral crura: a method to treat the bulbous nasal tip.
abstract: BACKGROUND
  The term "bulbous nose" is used to describe a large or boxy nasal tip. Typically, correction of the bulbous tip has been achieved through a variety of cartilage-modifying maneuvers based on incision or excision of the lower lateral cartilage.
  
  
  METHODS
  Horizontal reduction with a cephalic hinged flap of the lateral crura was used for 28 patients during open rhinoplasty. Effort was made to preserve the structural integrity of alar cartilage as much as possible with this technique.
  
  
  RESULTS
  The average follow-up period was 14 months. Satisfactory results were achieved. External nasal valve collapse and pinch deformity were not observed during the postoperative period.
  
  
  CONCLUSIONS
  The described technique improves nasal tip reduction while maintaining nasal tip support and strength. The hinged flap used with this technique can both prevent weakness of the lateral crura and support it.
authors.affiliation: Department of Otolaryngology, Head, and Neck Surgery, Faculty of Medicine, Vali-Asr Hospital, Imam Khomeini Medical Complex, Tehran University of Medical Sciences, Tehran, Iran. asazgar@sina.tums.ac.ir
authors.forename: Amir A
authors.initials: AA
authors.lastname: Sazgar
mesh_terms: D006801:Humans; D012225:Rhinoplasty / Q000379:methods*; D013524:Surgical Flaps