All patients underwent surgery under general anesthesia. After the local anesthetic was applied to the incision sites and dissection planes, an inverted-V incision and marginal incisions were performed. The columellar flap was elevated by using sharp curved scissors. Then the columella, domes, and lateral crura were dissected free of the surrounding soft tissues. By doing so, an undistorted view of the lower lateral cartilages could be obtained, which was very important in decision making. At this point in the operation, the shape, orientation, resiliency, thickness, width, and symmetry of the lateral crura were evaluated. In almost all of the patients, I was willing to leave at least 7 mm of lateral crus on both sides in women and 8 mm in men. To apply the technique presented herein, the width of the lateral crus had to be at least 12 mm (Figure 1). In this technique, all the soft tissues over the lateral crus were dissected away to put the whole lateral crus under direct exposure. The attachment of the lateral crus with the upper lateral cartilage (ULC) was also cut in the first 5 cases. The scroll area was kept intact in subsequent cases so as not to disturb the internal nasal valve angle. The underlying skin of the lateral crus was first injected with lidocaine hydrochloride containing adrenaline (1:100.000) for hydraulic dissection and hemostasis. Then it was dissected from the lateral crus, approaching from the cephalic border while keeping 1 to 3 mm of skin attached to the caudal border. A caliper was used to measure a distance of 7 to 8 mm from the caudal border of the lateral crus (the width to leave behind), and a marking pen was used to draw a straight line from the dome to the lateral border of the lateral crus (Figure 2). A No. 11 blade was used to make a partial cut on the outer surface of the lateral crus by following a straight line, the free cephalic portion was turned in, and the folded cartilage was sutured by using three 5-0 PDS mattress sutures, leaving the knot on the lateral surface of the lateral crus. The first suture was put into the midline, the second closer to the dome, and the third closer to the lateral margin. When these sutures were tied, both segments of the lateral crus became joined in a sandwich fashion. The width of the cartilage left behind was usually 7 to 8 mm, and the width of the turned-in cartilage was at least 4 to 7 mm, meaning that the lateral crus could be supported almost throughout its entire length. The detached skin was then sutured to the lateral crus by 5-0 rapid Vicryl mattress sutures to close the dead space and to help the skin to reattach to the lateral crus.