Video 4.6: ST Flap (Superior-Based Transposition Flap) – Live Surgical Application

What this video shows

Video 4.6 is the live surgical application of the ST flap, the superior-based transposition flap described by Prof. Dr. Suleyman Tas in Aesthetic Surgery Journal. Unlike the classic cephalic trim, which removes cartilage and weakens the lower lateral cartilage, the ST flap answers the question the book poses: can a technique strengthen the lower lateral cartilage, solve its orientation, correct convexity and concavity, give the bulbous tip a gentler triangular shape and support the middle vault by increasing the internal valve angle at the same time?

After exposure of the lower lateral cartilage, an incision is made in the caudal part of the lateral crus leaving a 6 mm main body, and the cephalic cartilage is transposed on its scroll-based pedicle rather than discarded. Video 4.7 shows the same technique as an animation.

Key points

• Alternative to cephalic trim that keeps and repositions the cartilage.

• Corrects convexity/concavity and bulbous tip while supporting the internal valve.

• 6 mm main body of the lateral crus is preserved.

For patients: the ST flap refines a bulbous tip without removing supporting cartilage, so the tip stays strong and breathing is protected.

In the book: Chapter 4 – Nasal Tip Surgery, section 4.3.3 ST Flap – 4.3.3.1 Surgical Technique, pp. 86–90 of Rhinoplasty in Practice: An Algorithmic Approach to Modern Surgical Techniques (CRC Press, 2021). About the book and all companion videos.

Related publication record: Superior-Based Transposition Flap: A Novel Technique in Rhinoplasty.

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.