Central Platform Surgery for Large and Deviated Noses -The Libra Flap: Low Septal Strip Dorsal Y Preservation.

Abstract

Traditionally, dorsal reconstruction is required after osseocartilagenous resection in patients with large noses where the cartilaginous dorsum is overdeveloped and wide, rendering it impossible for preservation. We aim to reduce the need for dorsal reconstruction by changing the resection technique in such noses. The present article describes and evaluates a technique, which consists of an anatomic resection of the nasal dorsum that we propose to be used in those patients who fall in the grey zone between requiring traditional DP and structural techniques. Dorsal Y preservation pre-cuts the intended dorsal aesthetic lines defining a central platform that can be flexed, lowered or moved laterally. A total of 77 patients who underwent low septal strip dorsal Y preservation by two different surgeons were studied retrospectively. Of the total patients, 85.7% (66) were female and 14.3% (11) were male. A closed approach was used in all cases. The patients were followed up from 6-36 months with a median follow up of 13 months. The central platform (Libra flap) technique provides anatomical results in patients with large, wide noses and an axis deviation. For those cases with other challenges, dorsal preservation and structure techniques should remain as preferred treatment modalities.