**4. Lateral crural anchorage flap**

In this technique, excessive parts of the lateral crural cartilages that are routinely excised and resected in tip plasty are marked on both sides. Cartilage incisions are made and excessive cartilage is separated from its underlying skin in a way that its medial attach‐ ments remain intact. Excessive cartilages are easily omitted while two cartilage flaps with a strong attachment to medial crural cartilage are available. These two flaps are used to rotate the nasal tip. Cartilage flaps are fixed with a needle to the nasal septum. The maneuver may be done for several times to find the ideal tip position. Then the flaps are precisely fixed with sutures to the nasal septum. [17]

#### **4.1. Important points**

This technique is based on two cartilage flaps that are in fact excessive parts of the lower lateral cartilages. These cartilages are supposed to be trimmed and resected in normal rhinoplasty. It is clear that in weak cartilage, or in case a small strip of cartilage is to be trimmed this approach will not be possible.

#### **4.2. Weak lower lateral cartilages and pinch deformity**

Strength and consistency of lower lateral cartilages play an important role in shape and function of the lower one third of the nose. Many techniques have been proposed to reinforce and reshape the lower lateral cartilages; all may be used in specific indications:


This technique:


#### **Indications:**

