Increasing the length of the middle crura for better tip projection in primary rhinoplasty.

Cartilage grafts have been a very popular method for achieving tip projection in difficult noses. Sometimes asymmetries and graft visibility are undesirable complications. Remodeling the alar cartilages, using a cartilage flap from the lateral crura, rotated over the original domes, is another alternative for achieving tip refinement and projection. The surgical technique is described and clinical results are presented.