title: The sandwiched lateral crural reinforcement graft: a novel technique for lateral crus reinforcement in rhinoplasty.
abstract: BACKGROUND
  Misshapen or weak lateral crura can cause an inward collapse of the lateral crus observed on deep inspiration. The lateral crural strut graft is a popular technique for reinforcing lateral crura. Failure to stabilize the graft properly can, however, result in graft displacement postoperatively and an accompanying aesthetic deformity.
  
  
  OBJECTIVE
  The authors discuss lateral crus reinforcement with the sandwiched lateral crural reinforcement (SLCR) graft.
  
  
  METHODS
  An SLCR graft was placed in 30 nonconsecutive primary open-approach rhinoplasty procedures by the senior author (İ.K.) between February 2010 and May 2012. Cephalic excess of the lateral crura was incised and placed under the lateral crura; the lateral crural strut grafts were placed between the 2 cartilages, and the cephalic edges of both the superior and inferior lateral crura segments were sutured together.
  
  
  RESULTS
  Of the 30 patients, there were 5 men and 25 women ranging in age from 22 to 45 years (median, 35 years). Half (50%) of the patients received the SLCR graft for external valve collapse; in 30% of the patients, it was placed to support the lateral crura after correcting cephalic malpositioning; and 20% had an SLCR graft placed for lateral crural reinforcement after deformity secondary to dome-shaping sutures. No graft displacement or tip disfigurement was observed in the follow-up period (mean, 24 months).
  
  
  CONCLUSIONS
  The SLCR graft technique represents a powerful tool for reinforcing lateral crura without discarding the cephalic portion of the cartilage, thus securing a stable graft pocket while minimizing any postoperative structural dislocation.
  
  
  METHODS
  4.
authors.affiliation: Dr Kuran is a plastic surgeon in private practice in Istanbul, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Kuran
authors.forename: Ali Rıza
authors.initials: AR
authors.lastname: Oreroğlu
mesh_terms: D000328:Adult; D002356:Cartilage / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000473:pathology / Q000601:surgery*; D012225:Rhinoplasty / Q000379:methods*; D055815:Young Adult
keywords: cephalic excess; cephalic malposition; graft displacement; lateral crural strut; lateral crus reinforcement; parenthesis tip; rhinoplasty; sandwiched crural reinforcement graft