The medial crural suture technique: Long-term columellar narrowing resulting in increased tip projection and rotation

The technique of columellar narrowing in individuals with widely separated medial crura is described by the authors. The medial crural suture technique is a procedure that can be performed in addition to other techniques utilized during aesthetic rhinoplasty to address undesirable characteristics. Other techniques such as the lateral crural flap technique can be used concurrently to increase nasal tip rotation while simultaneously decreasing tip projection. In the rhinoplasty patient presenting with a widened columella due to widely separated medial crura, partial removal of the levator septi nasi muscle with absorbable transcutaneous suture approximation of the medial crura maintains lasting narrowing of the preoperatively widened columella.