Auto-Rim Flap Technique for Lateral Crura Caudal Excess Treatment.
BACKGROUND
There are many variables that influence nose tip harmony. Even in a rhinoplasty that appears successful in profile, one may see nostril asymmetries, alar retractions, or irregularities in the soft triangle, and patients express their dissatisfaction with these simple deformities.


OBJECTIVE
In this study, we define the ratio of caudal and cephalic excess of the lower lateral cartilage. We evaluate whether it is possible to eliminate nostril asymmetries and alar retractions by means of supporting the facet polygon with the help of a lower lateral cartilage auto-rim flap, a technique we have developed in our rhinoplasties.


METHODS
The auto-rim flap was used successively on 498 primary rhinoplasty patients on whom the same surgeon operated between May 2013 and June 2015, performing marginal incisions.


RESULTS
Of the 498 patients in the series, only 1 of the first 10 required a revision due to tip asymmetry related to the auto-rim flap. A minimal nostril asymmetry that did not require intervention occurred in 10 patients. In none of the patients could an increased alar retraction be seen postoperatively. All patients exhibited alar cartilage in the anatomically correct position.


CONCLUSIONS
With the auto-rim flap technique, a part of the caudal excess of the alar cartilage remains as a flap in the facet region; therefore, there is no need in the cephalic region to perform more of an excision than what is strictly necessary.


METHODS
4 Therapeutic.
Dr Çakır is a plastic surgeon in private practice in İstanbul, Turkey. Dr Küçüker is an Assistant Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery, Ondokuz Mayıs University, Faculty of Medicine, Samsun, Turkey. Dr Aksakal is a Plastic Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Samsun Education and Research Hospital, Samsun, Turkey. Dr Sağır is a Plastic Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Fulya Acıbadem Hospital, İstanbul, Turkey.
Barış
B
Çakır
Dr Çakır is a plastic surgeon in private practice in İstanbul, Turkey. Dr Küçüker is an Assistant Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery, Ondokuz Mayıs University, Faculty of Medicine, Samsun, Turkey. Dr Aksakal is a Plastic Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Samsun Education and Research Hospital, Samsun, Turkey. Dr Sağır is a Plastic Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Fulya Acıbadem Hospital, İstanbul, Turkey drismailkucuker@yahoo.com.tr.
İsmail
İ
Küçüker
Dr Çakır is a plastic surgeon in private practice in İstanbul, Turkey. Dr Küçüker is an Assistant Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery, Ondokuz Mayıs University, Faculty of Medicine, Samsun, Turkey. Dr Aksakal is a Plastic Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Samsun Education and Research Hospital, Samsun, Turkey. Dr Sağır is a Plastic Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Fulya Acıbadem Hospital, İstanbul, Turkey.
İbrahim Alper
İA
Aksakal
Dr Çakır is a plastic surgeon in private practice in İstanbul, Turkey. Dr Küçüker is an Assistant Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery, Ondokuz Mayıs University, Faculty of Medicine, Samsun, Turkey. Dr Aksakal is a Plastic Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Samsun Education and Research Hospital, Samsun, Turkey. Dr Sağır is a Plastic Surgeon, Department of Plastic, Reconstructive, and Aesthetic Surgery, Fulya Acıbadem Hospital, İstanbul, Turkey.
Hacı Ömer
HÖ
Sağır
D000293:Adolescent; D000328:Adult; D059925:Anatomic Landmarks; D004954:Esthetics; D005260:Female; D006801:Humans; D008875:Middle Aged; D055171:Nasal Cartilages / Q000033:anatomy & histology / Q000601:surgery*; D017060:Patient Satisfaction; D010781:Photography; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012225:Rhinoplasty / Q000009:adverse effects / Q000379:methods*; D013524:Surgical Flaps; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult