Background: Resection of the cephalic or middle portion of lateral crura of alar cartilages is a method for correcting bulbous nose in which the resected cartilages usually are discarded, resulting in a waste of autologous tissues. A silastic implant usually is used to correct saddle nose in Asian countries, but implant extrusion, a severe complication, sometimes occurs. Cartilage flaps were first reported by José to increase the projection of the nasal tip. In this study, the authors used cartilaginous flaps of the lateral crura to wrap the tip of the nasal implant for patients with bulbous and saddle noses. This study aimed to investigate the application of cartilaginous flaps of lateral crura.
Methods: A flap was created from the cephalic portion of the lateral crus of the alar cartilage, leaving the caudal portion intact. The cartilage flap remained attached at the level of the original domal segment of the middle crura. It was rotated over to wrap the tip of the silastic implant, then sutured to the other side flap.
Results: From March 2003, 19 patients were treated with this technique. The results were satisfactory without implant extrusion or any other complications except for nonobvious scars.
Conclusion: The cartilage flap can reduce the incidence of implant extrusion and help to reduce the size of the bulbous tip.