Accuracy of predissection assessment of the lower lateral cartilage configuration: A cadaveric study

Abstract

Background: Preoperative planning of nasal tip surgery requires an accurate assessment of the nasal tip cartilages configuration. The current literature lacks any evidence on the accuracy of preoperative assessment of the lower lateral cartilages (LLC) shape. Objective: This study was designed to determine the accuracy of the LLC shape and configuration assessment prior to dissection. Methods: The configuration of the lateral, middle, and medial crura was assessed on 42 LLC (21 cadavers) prior to dissection by way of observation and palpation. The findings were then compared with those observed after LLC exposure through an open-approach dissection. Results: The accuracy of predissection LLC shape assessment was 42 of 42 (100%), 32 of 42 (76%), and 12 of 42 (29%) for medial, middle, and lateral crus, respectively. Conclusions: The configuration of the lateral crus of LLC cannot be accurately assessed prior to exposure of the cartilage. A rhinoplastic surgeon who embarks on nasal tip surgery should be familiar with a number of techniques to address any tip deformity encountered after exposure, as the preoperative clinical and photographic assessments cannot reliably demonstrate the type of LLC deformity. © 2010 The American Society for Aesthetic Plastic Surgery, Inc.