Complications of Rhinoplasty - Page 5

Increase rotation

Lateral crural steal
Transdomal suture that recruits lateral crura medially Base-up resection of caudal septum (variable effect) Cephalic resection (variable effect) Lateral crural overlay
Columellar strut (variable effect) Plumping grafts (variable effect)
Illusions of rotation—increased double break,
plumping grafts (blunting nasolabial angle)

Decrease rotation (counterrotate)

Full-transfixion incision
Double-layer tip graft
Shorten medial crura
Caudal extension graft
Reconstructed L strut, as in rib graft reconstruction (integrated dorsal graft/columellar strut) of saddle nose

Increase projection

Lateral crural steal (increased projection, increased rotation)
Tip graft
Plumping grafts
Premaxillary graft
Septocolumellar sutures (buried) Columellar strut (variable effect) Caudal extension graft

Decrease projection

High partial- or full-transfixion incision
Lateral crural overlay (decreased projection, increased rotation)
Nasal spine reduction
Vertical dome division with excision of excess medial crura, with suture reattachment

Increase length

Caudal extension graft Radix graft
Double-layer tip graft Reconstructed L strut

Decrease length

See increased rotation
Also, deepen nasofrontal angle