# Internal mucosal resection and LLC suspension: a new method to establish a stable tip rotation angle and reduce the nasal bridge length

## TL;DR

A new surgical technique is introduced to control nasal tip rotation and reduce nasal bridge length, with promising long-term results.

## Contribution

A novel surgical method combining internal mucosal resection and LLC suspension is proposed for nasal tip rotation and bridge length control.

## Key findings

- The technique achieved an average 19° increase in nasolabial angle immediately post-surgery.
- Nasal bridge length was reduced by an average of 1.11 cm immediately after surgery.
- The technique showed more significant effects in patients with longer noses.

## Abstract

Herein, we describe a new technique to obtain both the appropriate degree of rotation angle and the ideal nasal bridge length. The aim of this study is to investigate the long-term results of this new technique with regard to these two variables.

A total of 76 (27 males, 49 females) patients were operated in accordance with the presented technique. Internal caudal mucosal excision and lower lateral cartilage (LLC) suspension were applied to all the patients included in this prospective study. Preoperative, immediate postoperative, and postoperative 1st-year photographs were taken. NOSE scores were obtained in the postoperative 1st year.

The mean nasolabial angle values of the patients preoperatively, at the end of the surgery (immediate postoperative), and at the end of the first year were 94.13° ± 5.1, 113.1° ± 5.3, and 109.6° ± 5.2, respectively. The patients had an average gain of 19° at the nasolabial angle at the end of the surgery and experienced a 3.5° (3.1%) loss at the end of the first year. For the nasal bridge length (n-prn) values; the preoperative, immediate postoperative, and first year mean values were 5.1 ± 0.55 cm, 3.98 ± 0.41 cm, and 4.29 ± 0.39 cm, respectively. The noses of the patients were shortened by 1.11 cm on average at the end of the surgery.

Internal caudal mucosal resection with a suspension of the LLC to the caudal edge of the upper lateral cartilages (ULC) offers a reliable method to control the nasal tip rotation and shorten the long noses. This technique’s effect is more obvious in long noses compared to the short ones.