How often in rhinoplasty are "lower lateral cartilages repositioned" and why is this done?

Question

Why are lower lateral cartilages repositioned in rhinoplasty? What kind of results do these produce?

P. Daniel Ward, MD · Answer

The lower lateral cartilages can be a significant source of tip bulbosity and fullness. Moving these cartilages to a more caudal (inferior) position can lead to a more natural and elegant nasal appearance.

Evan Ransom, MD, FACS · Answer

Thank you for the question! The lower lateral cartilages make up the bulk of the nasal tip. The majority o cosmetic rhinoplasty procedures involve some change to these structures. Repositioning can mean a variety of things; broadly taken, the lower lateral cartilages are repositioned quite often, including rotating them upward, moving them up or down in projection, etc. The maneuver that you are most likely referring to involves making a new pocket for the lateral ends of these cartilages in patients with vertically-oriented cartilages or significant alar (nostril rim) retraction. This is much less common, and is porbably performed in 10% or less of primary rhinoplasty cases. The goal is to decrease tip bulbosity (roundness) while also making the nostrils look and function better. Best of luck!!!

Andre Panossian, MD · Answer

Repositioning the LLCs must be defined more precisely to understand the purpose behind it. In most instances, people are referring to changing the orientation of the LLC to remove some of the bulbosity of the tip. However, repositioning can also mean adding or decreasing length of the tip by changing the point of angulation that is responsible for the tip defining points. Along with this idea, a wide tip can be narrowed slightly.

Mohsen Tavoussi, MD, DO · Answer

There are number of reasons lower lateral cartilages are repositioned depending on the type of deformity one tries to correct. Most often, we use this technique to correct alar  retraction both for congenital or post surgical alar retractions. Suturing of nasal tip, which commonly used to refine the tip, can also lead to some alar repositioning. Alar notching can also be  corrected with repostioning of lateral alar cartilages.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Repositioning the lower alar cartilages should only be done if the lower alar cartilages are truly pointed superiorly (we call it cephalad). This is usually not the case though as the upper lateral cartilages keep the lower lateral cartilages down by way of the scroll (cartilage junction). The usual problem is that the lower lateral cartilages are obtuse (curved ) and have to be flattened; I prefer a horizontal mattress stitch for this rather than moving them to a non-anatomical location.

How often in rhinoplasty are "lower lateral cartilages repositioned" and why is this done?

Answers (5)

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