Lateral Crural Steal Technique and its Influence on Tip Rotation in Rhinoplasty

Achieving predictable and aesthetically pleasing nasal tip rotation is a fundamental objective in rhinoplasty. The lateral crural steal (LCS) technique is widely used to improve nasal tip projection and rotation by modifying the lower lateral cartilages. This study aimed to evaluate the effect of the LCS technique on nasal tip rotation in patients undergoing primary open rhinoplasty. A retrospective cohort study was conducted on 47 consecutive patients who underwent primary open rhinoplasty with the LCS technique between January 2021 and December 2023. The study included 34 females and 13 males with a mean age of 28.4 ± 6.1 years. Standardized preoperative and postoperative lateral photographs obtained after a mean follow-up of 14.5 ± 2.3 months were analyzed. Nasal tip rotation was assessed using the nasolabial angle (NLA). Preoperative and postoperative measurements were compared using the paired t-test. The mean preoperative NLA was 94.2 ± 5.8°, which increased significantly to 101.5 ± 4.9° after surgery. The mean improvement in NLA was 7.3 ± 2.1°, demonstrating a statistically significant enhancement in nasal tip rotation (p < 0.001). Intraoperative assessment showed that moderate increases in the nasal tip angle were achieved in most patients, while a predictable reduction occurred after wound closure without compromising the overall postoperative improvement. No major complications were observed. The lateral crural steal technique is a reliable and effective method for improving nasal tip rotation in primary rhinoplasty. It produces significant increases in the nasolabial angle while preserving nasal tip support and maintaining a low complication rate. Careful surgical planning and meticulous operative technique are essential to achieve consistent and aesthetically satisfactory outcomes.