Journal archive · Revision and secondary rhinoplasty · Rib, ear and septal grafts · Nasal tip · Cleft, trauma and reconstruction · 2017
Lateral Crural Reinforcement in Secondary Cleft Lip Nasal Deformity Through a Combined Lateral Crural Turn-over Flap and Strut Graft
Han J, Baek RM, Kim BK.
In the archive as a landmark paper: the core sweep runs 2011–2026, and this one is here because the history of rhinoplasty rests on it · cited on subalar graft.
From the abstract
“Secondary cleft lip nasal deformity is a complex deformity, and the variety of recommended techniques used to correct this deformity attests to it. Much of the nasal deformity can be attributed to an abnormal lower lateral cartilage. This study presents our experience with applying a lateral crural turnover flap with…”
Excerpt; the full abstract is on PubMed.
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What the rhinoplasty literature says on this paper's topics, cited line by line to PubMed.
Revision and secondary rhinoplasty
Between 5% and 15% of rhinoplasties are done again, and the published series say the second operation is a different problem from the first: the cartilage is gone, the skin is scarred and less able to survive, and the airway is usually part of the complaint.
Rib, ear and septal grafts
Modern rhinoplasty builds rather than removes, so the operation runs on cartilage: the septum first, then the ear, then the rib, and when none of those will do, a piece of donated rib from a tissue bank.
Nasal tip
Tip surgery is now a support problem rather than a sculpting problem: the septal extension graft holds projection and rotation where the columellar strut loses them (0.2% against 4.7% projection loss at one year), and the current series repair, reposition and reinforce the lower lateral cartilages instead of excising them.
Cleft, trauma and reconstruction
A cleft nose is a sequence spread across a childhood: a repair at three months, sometimes a second at five or six, and a definitive rhinoplasty once the face has finished growing.
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