Articulated Infra-Domal Columellar Flap, a Technical Note.

Soft tissue triangle notching represents a complex challenge in rhinoplasty. To prevent this esthetic complication, various techniques have been developed. When soft tissue triangle notching occurs, both surgical procedures and nonsurgical methods like steroid injections and taping can be considered. Surgical management of alar and tip deformities involves the use of cartilage grafts and cartilage flaps. While cartilage grafts are effective in most cases, they may have associated limitations. On the other hand, cartilage flaps have advantages over cartilage grafts, including easier fixation, avoidance of cartilage harvesting, and the ability to use similar tissue for reconstructing the recipient site. In this study, we present a novel cartilage flap technique for addressing soft tissue triangle retraction, suitable for open, closed, and preservation rhinoplasty approaches.