Correcting the convex lateral crura of the lower alar cartilages

Abstract

The size, shape, and orientation of the lower lateral crural cartilages of the nose affect the aesthetic appearance of the lower nasal third and, at times, nasal airway function. The lower lateral crura should ideally be slightly concave in the anterior one-third and flat in the posterior two-thirds. More excessive convexity along the lower lateral crura is often seen in the boxy, bulbous, and parentheses tip deformities. The authors describe clinical evaluation and discuss management with scoring/cartilage weakening, lateral crural mattress suturing, interdomal/transdomal/lateral crural spanning sutures, dome division, lateral crural overlay, lateral crural turnover graft, lateral crural strut graft, and lower lateral crural reversal.