Nasal cartilages: upper lateral and alar cartilages
- Highlighted area
Quick facts
- Upper lateral cartilages
- A pair of cartilages that forms the middle third of the dorsum, attached beneath the nasal bones.
- Greater alar cartilages
- A pair of C-shaped cartilages that shape the tip, the columella and the alae, each with a medial and a lateral crus.
- Septal
- A central plate that divides the nostrils and supports the dorsum and the tip.
- Nasal ala
- Has little cartilage at its edge; it is formed largely by fibrofatty tissue.
- Relevance in HOF
- Explains what filler can and cannot change in the nose and why the tip is a risk area.
The nasal cartilages form the mobile framework below the nasal bones. There are three main structures: the upper lateral cartilages, which support the middle third of the dorsum; the greater alar cartilages, C-shaped, which shape the tip, the columella and the rim of the nostrils; and the septal cartilage, a central plate that divides the nostrils and supports the dorsum and the tip. Together with the nasal bones and the piriform aperture, they define the contour of the nose and the limits of nonsurgical rhinoplasty.
What are the cartilages and what does each one shape?
| Structure | Where it is | What it defines in the contour |
|---|---|---|
| Nasal bones | Upper third of the dorsum | Root and upper part of the dorsum |
| Upper lateral cartilages | Middle third of the dorsum, under the edge of the nasal bones | Width and line of the middle dorsum |
| Septal cartilage | Midline, between the nostrils | Height of the dorsum, support of the tip |
| Greater alar cartilages, medial crus | Columella | Tip height and shape of the columella |
| Greater alar cartilages, lateral crus | Side of the tip, above the nostril rim | Width and shape of the tip |
| Accessory cartilages and fibrofatty tissue | Rim and side of the ala | Shape of the ala, which has little cartilage |
Two junctions are frequent landmarks. The area where the nasal bones, upper lateral cartilages and septum meet, on the dorsum, is called the keystone, the supporting region of the dorsum. The area where the upper lateral cartilage meets the alar cartilage, on the side of the nose, is the scroll region, which influences the transition between dorsum and tip.
Why does it matter in HOF?
- What volume can do: in nonsurgical rhinoplasty, volume can camouflage a dorsal hump, soften the root and change how the nasofrontal angle and the tip are perceived. The result depends on how the framework is built.
- What it cannot do: filler does not make the nose smaller, does not slim a wide tip, does not correct a deviated septum and does not narrow the base. Tips with weak cartilage or thick skin have little room for change.
- Muscle and tip: the depressor septi nasi muscle pulls the tip down when smiling, which changes the dynamic nasolabial angle.
- Previous surgery: rhinoplasty alters cartilages, scars and blood supply, and changes the risk of any later procedure.
How does it show up in the assessment?
- Palpation: separating the bony part from the cartilaginous part on the dorsum and feeling the firmness of the tip.
- Frontal, profile and basal views: deviations, dorsal width, tip shape and nostril symmetry.
- Smile: drooping of the tip caused by the depressor septi.
- History of rhinoplasty and trauma.
The comparison between the options is in nonsurgical rhinoplasty or surgical rhinoplasty, and the complications are in nasal vascular occlusion.
Also called: cartilaginous framework of the nose, triangular cartilages (upper lateral), alar cartilages (lower lateral).
Frequently asked questions
What are the cartilages of the nose?
The main ones are the two upper lateral cartilages, which form the middle of the dorsum, the two greater alar cartilages, which form the tip and the alae, and the septal cartilage in the center. There are also small accessory cartilages at the side of the ala.
Can filler make the nose smaller?
No. Filling adds volume, so it does not reduce a dorsal hump, the width or the size of the tip. What volume can do is camouflage irregularities and change how the profile is perceived, within the limits that the framework and the skin allow.