Lower lateral crural turnover flap combined with alar batten graft for the long-term result of the treatment of alar convexities

Philippine Merlin, Amanda Fanous, Jean-Paul Marie, Nicolas Bon Mardion, Nadia Benmoussa


Introduction: Concave lower lateral cartilages not only cause an esthetic defect but can also lead to external nasal valve insufficiency. The objective of this article is to analyze the combination of two well-known surgical techniques: turning over the alar cartilages as well as the addition of grafts in order to obtain satisfying esthetic and functional long term results. Materials and methods: From August 2016 to July 2018, 62 rhinoplasties, a combination of both primary and revision cases, were performed at the Rouen University Hospital in France. Six of these involved the correction of concave alar cartilages. The turnover technique alone or in combination with Batten grafts was performed. Results: Immediate and 3-months post-operative esthetic results using the turnover flap technique were satisfactory. Alar batten grafts were occasionally employed in order to maintain the newly positioned alar cartilages and avoid long-term contour depressions. Conclusion: The combination of these two techniques seems to be an interesting solution to maintain long-term esthetic results.


alar convexity; rhinoplasty; alar batten graft; nasal tip; nasal valve

Full Text:



Gruber RP, Nahai F, Bogdan MA, Friedman GD. Changing the convexity and concavity of nasal cartilages and cartilage grafts with horizontal mattress sutures: part I. Experimental results. Plast Reconstr Surg 2005; 115(2):589–594.

Neu BR. Suture correction of nasal tip cartilage concavities. Plast Reconstr Surg 1996; 98(6):971–979.

Becker DG, Becker SS. Treatment of nasal obstruction from nasal valve collapse with alar batten grafts. J Long Term Eff Med Implants 2003; 13(3):259–269.

Toriumi DM, Josen J, Weinberger M, Tardy ME. Use of alar batten grafts for correction of nasal valve collapse. Arch Otolaryngol Head Neck Surg 1997; 123(8):802–808.

Fischer H, Gubisch W. Nasal valves--importance and surgical procedures. Facial Plast Surg 2006; 22(4):266–280.

Haack S, Gubisch W. Lower lateral crural reverse plasty: a technique to correct severe concavities of the lateral crus. Aesthetic Plast Surg 2011; 35(3):349–356.

Janis JE, Trussler A, Ghavami A, Marin V, Rohrich RJ, Gunter JP. Lower lateral crural turnover flap in open rhinoplasty. Plast Reconstr Surg 2009; 123(6):1830–1841.

Çakır B, Öreroğlu AR, Daniel RK. Surface Aesthetics and Analysis. Clin Plast Surg 2016; 43(1):1–15.

DOI: http://dx.doi.org/10.22551/2019.22.0601.10147

Copyright (c) 2019 Philippine Merlin, Amanda Fanous, Jean-Paul Marie, Nicolas Bon Mardion, Nadia Benmoussa

Creative Commons License
Archive of Clinical Cases is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.


ISSN: 2360-6975