Cosmetic and Functional Effects of Cephalic Malposition of the Lower Lateral Cartilages: A Facial Plastic Surgical Case Study
Authors are: Dr. Cory Yeh and Dr. Edwin F. Williams, III
In summary, cephalic malposition of the lower lateral cartilages is a frequent anatomic variation of nasal anatomy. Alar cartilage malposition results in cosmetic changes to nasal contour including nasal tip fullness and characteristic tip configurations such as the boxy tip, ball tip, or parentheses tip. Further, cephalic malposition is often associated with significant external nasal valve weakness that can result in nasal obstruction. The surgeon must become facile with an analysis of surface topography to suspect alar cartilage malposition preoperatively to avoid iatrogenic injury to the lower lateral cartilage during standard rhinoplasty maneuvers. If external valve collapse is present, an open approach or endonasal approach can be used to strengthen the valve through placement of batten or alar rim grafts, or through cartilage repositioning techniques.
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