A New Flap for Nasal Tip Contouring and Rotation Lower Lateral Cartilage-Based Ligamento-Perichondrial Flap

Background: Management of nasal tip contour and rotation has always been the most important step of rhinoplasty. Several tipplasty methods such as suturing, grafting, and excisions have been performed for each good postoperative results. Objectives: In this article, how the authors use a new flap for nasal tip contouring and rotation was shared with plastic surgeons. Methods: Twenty-four patients who underwent open rhinoplasty were evaluated between the years of 2015 and 2018. The average age of patients was 25.4. All patients were operated for primary rhinoplasty. Four of the patients had cleftlip nose deformity. During open rhinoplasty, the authors created a lower lateral cartilage-based ligamento-perichondrial flap (LPF) for tip contouring. All flaps were sutured in desired place to reach a natural, symmetric, smooth, elevated, and well-shaped tip. Histologic evaluation was performed in 2 patients to revaluating the structural integrity of LPF. Nasolabial angles were measured and changes were evaluated at postoperative first and sixth months in 13 patients for whom LPF was used for increasing the nasolabial angle and tip rotation. Results: Patients were followed for an average of 1 year. No LPF-related complications were encountered. Histologic examination revealed that all levels of LPF had rich vascularity. Postoperative nasolabial angle changes were not statistically significant ( P >0,05). Conclusions: The authors described a new LPF and its combination with tipplasty techniques. The authors believe that this is a useful vascular supportive tissue for tip contouring and rotation.