Lateral crural resting angle in rhinoplasty: anatomical and aesthetic considerations

Abstract

Nasal tip reshaping in rhinoplasty is a highly technical procedure that requires an in-depth understanding of the three-dimensional anatomy of the nasal region. The resting angle of the lateral crus, ideally close to 100°, is a key determinant not only because it optimizes the shape and projection of the nasal tip, but also because it enhances alar rim support and strengthens the external nasal valve structure, thereby facilitating more efficient nasal respiration. The proper management of the lateral crura, through direct manipulation and/ or modifications of adjacent structures, must be carefully planned and executed. Numerous surgical techniques for correcting nasal tip morphology have been described in the literature and are detailed in this review. The selection of the appropriate technique, along with the overall surgical plan, should be based on a comprehensive preoperative assessment, which includes a thorough physical examination, analysis of the patient’s individual anatomical features, evaluation of external nasal valve function, and detailed preoperative photogra­phic analysis in multiple views. This work emphasizes the critical importance of a rigorous preoperative assessment, a thorough anatomical analysis, and the implementation of spe­cialized surgical techniques to accurately manage the resting angle, with the goal of achie­ving both aesthetically and functionally satisfactory outcomes.