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Surgical Technique
January 2008

The Lateral Crural Stairstep TechniqueA Modification of the Kridel Lateral Crural Overlay Technique

Author Affiliations

Author Affiliations: Department of Maxillofacial Surgery, S. Camillo Hospital, Rome, Italy (Dr Boccieri); and Department of Otorhinolaryngology, United Hospitals, Livorno, Italy (Dr Raimondi).

Correspondence: Armando Boccieri, MD, Viale Umberto Tupini 133, 00144 Rome, Italy (armando.boccieri@libero.it).

Arch Facial Plast Surg. 2008;10(1):56-64. doi:10.1001/archfacial.2007.7

Correspondence: Armando Boccieri, MD, Viale Umberto Tupini 133, 00144 Rome, Italy (armando.boccieri@libero.it).

The Kridel lateral crural overlay technique has proved capable of resolving overprojection with severe ptosis of the tip and can be used along with a medial crural overlay to reduce marked overprojection of the tip with no significant rotation. In the technique described herein, the section of the lateral crus involved in the lateral crural overlay is step-shaped rather than vertical and the cartilage is completely detached from the skin beneath as far as the domus. The anterior segment is moved downward and is overlapped with the posterior segment on both sides to resolve “parenthesis deformities” of the nasal tip that are caused by malposition of the lateral crura. This procedure can also be combined when necessary with both posterior and anterior sliding of the lateral crus to correct most deformities of the nasal tip. Within the framework of surgery on the nasal tip, attention has focused primarily on techniques that were designed to modify the projection and rotation of the nasal tip. It is only recently that a new parameter with important aesthetic and functional implications has emerged, namely cephalocaudal positioning in the space of the lateral crura.1

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