title: A technique to correct severe lateral crural concavity: adjunctive use of a polydioxanone plate during lateral crural reverse plasty.
abstract: BACKGROUND
  Severe lateral crura concavity (LCC) can lead to an important deformity of the nasal tip and to external nasal valve insufficiency. The lower lateral crural reverse plasty represents a valuable technique for the correction of severe LCC, but often requires additional cartilage to gain more alar rim support.
  
  
  METHODS
  We describe a modified version of the reverse plasty, in which a polydioxanone plate is sutured as a strut at the dome junction to increase alar rim support. We report our experience with this technique in 10 women (age range 24-56 years).
  
  
  RESULTS
  The procedure was performed in eight primary rhinoplasties and in two cases alone without rhinoplasty. All patients had aesthetic complaints, whereas three had obstructive symptoms. Eight patients had unilateral problems. A one-year follow-up was completed in 100 % of patients. There were no surgical complications and all patients had optimal short and long-term aesthetic and functional results.
  
  
  CONCLUSIONS
  Acikel C (Aesthetic Plast Surg 36:862-865, 2012) The adjunctive use of a polydioxanone plate during lateral crural reverse plasty was feasible and led to satisfying functional and cosmetic long-term results in patients with severe LCC. This surgical maneuver appears reproducible and emerges as an alternative way of gaining stronger support during lateral crura reverse plasty while avoiding additional tissue.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
authors.affiliation: Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Moina
authors.forename: Gabriel
authors.initials: G
authors.lastname: Moina
authors.forename: Alberto
authors.initials: A
authors.lastname: Rancati
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery; D009666:Nose / Q000002:abnormalities* / Q000601:surgery*; D016687:Polydioxanone / Q000627:therapeutic use*; D012225:Rhinoplasty / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome
chemical_list: D016687:Polydioxanone