Total reconstruction of the alar cartilages with a partially split septal cartilage graft

The alar cartilage is a unique structure that supports the tip of the nose, keeps the external valve open, and plays an important role in tip aestheti cs. Very often the plastic surgeon needs to reconstruct this cartilage, as in secondary rhinoplasties when the lower lateral cartilage is overresected . Many authors have described cartilage grafts taken from the ear and septu m, mounted and stitched in various manners, with some very good results. In patients with thin skin, though, any irregularity or distortion in the gra fts becomes visible after a short time postoperatively. The authors present an alternative to reconstructing alar cartilage symmetrically using one gr aft. This graft is obtained by shaping septal cartilage in an "L" form, wit h a 135-deg angle (instead of a 90-deg angle) between its legs, and then sp litting the smaller leg, obtaining a strut from the longer leg and two "lat eral crura" from the shorter leg.