The Medial Crural Suture Technique: Long-Term Columellar Narrowing Resulting in Increased Tip Projection and Rotation

Chapter

Abstract

The technique of columellar narrowing in individuals with widely separated medial crura is described by the authors. The medial crural suture technique is a procedure that can be performed in addition to other techniques utilized during aesthetic rhinoplasty to address undesirable characteristics. Other techniques such as the lateral crural flap technique can be used concurrently to increase nasal tip rotation while simultaneously decreasing tip projection. In the rhinoplasty patient presenting with a widened columella due to widely separated medial crura, partial removal of the levator septi nasi muscle with absorbable transcutaneous suture approximation of the medial crura maintains lasting narrowing of the preoperatively widened columella.

Keywords

Pythagorean Theorem Alar Cartilage Lower Lateral Cartilage Nasolabial Angle Medial Crura 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Joseph J (1931) Nasenplastick und Sonstige Gesichts­plastik nebst einen Anhang ueber Mammaplastik. Verlag von Curt Kabitzsch, LeipzigGoogle Scholar
  2. 2.
    Goldman IB (1954) Surgical tips on the nasal tip. Eye Ear Nose Throat Mon 33(10):583–586PubMedGoogle Scholar
  3. 3.
    Goldman IB (1957) The importance of the mesial crura in nasal-tip reconstruction. AMA Arch Otolaryngol 65(2):143–147PubMedCrossRefGoogle Scholar
  4. 4.
    Janeke JB, Wright WK (1971) Studies on the support of the nasal tip. Arch Otolaryngol 93(5):458–464PubMedCrossRefGoogle Scholar
  5. 5.
    Behmand RA, Ghavami A, Guyuron B (2003) Nasal tip sutures part I: the evolution. Plast Reconstr Surg 112(4):1125–1129PubMedCrossRefGoogle Scholar
  6. 6.
    McIndoe A, Rees TD (1959) Synchronous repair of secondary deformities in cleft lip and nose. Plast Reconstr Surg 24:150CrossRefGoogle Scholar
  7. 7.
    Tajima S, Maruyama M (1977) Reverse-U incision for secondary repair of cleft lip nose. Ann Plast Surg 60(2):256–261Google Scholar
  8. 8.
    Anderson JR (1970) The dynamics of rhinoplasty. In: Busta­ment GA (ed) Proceedings of the ninth ­international congress of otorhinolaryngology, Mexico City, 10–14 Aug 1969. Excerpta Medica, AmsterdamGoogle Scholar
  9. 9.
    Anderson JR (1984) A reasoned approach to nasal base surgery. Arch Otolaryngol 110(6):349–358PubMedCrossRefGoogle Scholar
  10. 10.
    Song R, Ma H, Pan F (2002) The “levator septi nasi muscle” and its clinical significance. Plast Reconstr Surg 109(5):1707PubMedCrossRefGoogle Scholar
  11. 11.
    Chen AH, Moretz WH, Perakis H, Champagne JP, Markarian A, Kamer FM (2010) Medial crura suture technique: long term columellar narrowing and extrapolated effect on tip projection and rotation. Am J Cosmet Surg 27(3):107–114Google Scholar
  12. 12.
    Rasband WS, Image J (1997–2011) U. S. National Institutes of Health, Bethesda, Maryland, USA. http://imagej.nih.gov/ij/. Accessed May 15, 2012
  13. 13.
    Crumley RL, Lanser M (1988) Quantitative analysis of nasal tip projection. Laryngoscope 98(2):202–208PubMedGoogle Scholar
  14. 14.
    Lawson W, Reino AJ (1995) Reduction columelloplasty: a new method in the management of the nasal base. Arch Otolaryngol Head Neck Surg 121(10):1086–1088PubMedCrossRefGoogle Scholar
  15. 15.
    Durante BJ, Porubsky ES (1988) Stabilizing the lateral crural flap in septorhinoplasty. Laryngoscope 98(1):117–119PubMedGoogle Scholar
  16. 16.
    Rich JS, Friedman WH, Pearlman SJ (1991) The effects of lower lateral cartilage excision on nasal tip projection. Arch Otolaryngol Head Neck Surg 117(1):56–59PubMedCrossRefGoogle Scholar
  17. 17.
    Guyuron B, Behmand RA (2003) Nasal tip sutures part II: the interplays. Plast Reconstr Surg 112(4):1130–1145PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Department of Otolaryngology – Head and Neck SurgeryGeorgia Health Sciences UniversityAugustaUSA
  2. 2.Department of Plastic and Reconstructive SurgeryUniversity of MinnesotaMinneapolisUSA
  3. 3.The Georgia Center for Facial Plastic SurgeryEvansUSA
  4. 4.Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology – Head and Neck SurgeryGeorgia Health Sciences UniversityAugustaUSA

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