Video 4.1: Lateral Overlapping Instead of Lateral Steal in Stiff Lower Lateral Cartilages

What this video shows

Video 4.1 illustrates a decision from the tripod concept, the model in which the two lateral crura and the conjoined medial crura form a tripod that determines tip rotation and projection. When an upward tip rotation is needed or the lateral crus has to be shortened, lateral steal is a simple and effective manoeuvre; however, if the cartilage is so stiff that it could break during lateral steal, the book advises lateral overlapping instead, which is what the video shows.

Table 4.1 of the book summarises how each manoeuvre (lateral steal, medial steal, lateral overlapping, medial overlapping) changes tip rotation, projection and the length of the lateral and medial crura; this video is the practical demonstration of that table.

Key points

• Lateral overlapping is chosen when the lateral crus is too stiff for lateral steal.

• Effect: increases rotation, decreases projection, shortens the lateral crus.

• Based on the tripod concept of nasal tip dynamics.

In the book: Chapter 4 – Nasal Tip Surgery, section 4.2.1 The Tripod Concept, pp. 73–74 of Rhinoplasty in Practice: An Algorithmic Approach to Modern Surgical Techniques (CRC Press, 2021). About the book and all companion videos.

Surgeon: Prof. Dr. Suleyman Tas, plastic, reconstructive and aesthetic surgeon, Istanbul. This video is part of the surgeon-training material of the book; patients considering rhinoplasty in Istanbul can use it to understand the techniques used at Prof. Dr. Suleyman Tas Clinic.