A. Conservative cephalic trim of the lower lateral cartilage.
B. Columellar strut sutured in place.
C. Shield shaped tip graft sutured in place.
D. Tip projection preservation with use of transfixion incision and the standard septocolumellar suture.
E. Mandatory incision-separation of the upper and lower alar cartilage.
REFERENCES & ANSWER
Toriumi D. M., Johnson C. M.: Open Structure Rhinoplasty, Featured Technical Points and Long-Term Follow-up, in Otolaryngologic Clinics of North America, Saunders, Vol. 1, Number 1, pp. 1-21, 1993
Adamson P. A., Litner J. A.: Open Rhinoplasty, Chapter 41 in Facial Plastic and Reconstructive Surgery, Thieme, Third Edition, pp. 529-546, 2009
260) E Mandatory incision-separation of the upper and lower alar cartilage.
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