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Page 8 of 14 Patel et al. Plast Aesthet Res 2024;11:20 https://dx.doi.org/10.20517/2347-9264.2024.17
Figure 7. Complete repositioning of the lower lateral crura with the use of lateral crural strut grafts is shown here. The thin vestibular
mucosa is dissected off the underside of the lower lateral cartilage, which enables complete mobilization of the alar sidewall. Placement
of a lateral crural strut under this cartilage and into a precise pocket allows for repositioning of the cartilage.
Figure 8. With reconstruction and repositioning of the lower lateral crura, complete mobilization of the alar sidewall is performed.
While a large amount of the crura can be replaced, one should attempt to preserve the tip/ domal cartilage as it is the most challenging
to reconstruct.
Figure 9. With reconstruction and repositioning of the lower lateral crura, the new lateral crural grafts can be placed in precise pockets
along the nasal sidewalls. Suture stabilization can be helpful, as shown here. This can be facilitated with the use of double-armed
needles, which are placed through the graft at the distal aspect and then inserted into the created pocket.
