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An Alternative Rhinoplasty Technique: Rotational Spreader Flap (“Rabbit Flap”)

  • Original Article
  • Rhinoplasty
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Abstract

Background

In modern rhinoplasty, septal cartilage is the most commonly used graft material. It is a big challenge if septal cartilage is insufficient. We present an alternative technique named the “rabbit flap,” created from the cephalic portion of the lower lateral cartilage to show its effectiveness on nasolabial angle, nasal axis deviation, and nasal dorsal line.

Methods

An alternative flap, called a “rabbit flap,” is constituted from the cephalic portion of the lower lateral cartilage (LLC). The key for this flap’s success is in not cutting the connection between the lateral and medial crus of the alar cartilage. The flap is rotated and placed between the upper lateral cartilage and the septum to ensure a spreader graft effect; it can also be moved forward and backward to adjust the nasal tip rotation. Patients whose minimum width of LLC was 12 mm were included in this study. We subjectively evaluated the results of this technique for 24 patients who completed the rhinoplasty outcomes evaluation (ROE) questionnaire and objectively by measuring the nasal axis and nasolabial angles in the preoperative and postoperative first-year periods.

Results

There were significant improvements in ROE, nasal axis deviation, and nasolabial angle scores when preoperative and postoperative first-year controls were compared (p < 0.001). We also observed no complications.

Conclusions

With this technique, we can correct both a nasal tip rotation and a mild nasal axis deviation. Moreover, we can achieve a proper nasal dorsal line and prevent an inverted V deformity. By expanding the internal nasal valve, a functionally effective surgery can be performed. However, the LLC must be strong enough to avoid alar collapse. In light of our results, we believe that the technique we call the “rabbit flap” can be used as an alternative rhinoplasty technique.

Level of Evidence IV

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Authors and Affiliations

  1. Uzmanlar Health Center, Istanbul, Turkey

    Ali Ahmet Sirin

  2. Medical Faculty, Gaziosmanpasa University, Kaleardı Mahallesi Muhittin Fisunoğlu Caddesi Ali Şevki EREK Yerleşkesi, 60100, Tokat, Turkey

    Ibrahim Erdim

  3. Medical Faculty, Selcuk University, Konya, Turkey

    Omer Erdur

  4. Medical Faculty, Acibadem University, Istanbul, Turkey

    Alperen Sirin

Authors
  1. Ali Ahmet Sirin
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  2. Ibrahim Erdim
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  3. Omer Erdur
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  4. Alperen Sirin
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Correspondence to Ibrahim Erdim.

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Sirin, A.A., Erdim, I., Erdur, O. et al. An Alternative Rhinoplasty Technique: Rotational Spreader Flap (“Rabbit Flap”). Aesth Plast Surg 42, 577–589 (2018). https://doi.org/10.1007/s00266-017-0999-4

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  • DOI: https://doi.org/10.1007/s00266-017-0999-4

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