It is widely acknowledged that rhinoplasty is the one of the most difficult operations to perform. Margins are unforgiving, particularly in thin-skinned patients, because even the smallest of irregularities and asymmetries are prominently visible on a triangular pyramid that projects from the face. A smooth, symmetrical, well-proportioned surface contour is the ultimate aesthetic goal for rhinoplasty, and the multitude of available techniques are aimed to achieve this end. However, before the rhinoplasty surgeon can even begin to go to work to alter the osseous and cartilaginous structures that create this surface contour, he or she must establish a stable midline foundation on which the more superficial anatomical elements can be built. The L-strut septum functions as this foundation. The rhinoplasty surgeon must therefore be adept at modulation of the nasoseptal L-strut, including its reconstruction.
Kim DW, Attenello NH. Reconstruction of the Nasoseptal L-Strut in Rhinoplasty. JAMA Facial Plast Surg. 2015;17(6):457-458. doi:10.1001/jamafacial.2015.1522