Freer Nasal Knife — Lower Lateral Cartilage Work

Freer Nasal Knife — Lower Lateral Cartilage Variant

Once the lower lateral cartilages have been delivered through the marginal incision the surgeon needs a finer knife to address the cephalic trim — the conservative excision of the upper edge of the lower lateral cartilage that narrows the supratip and refines the nasal tip without weakening the alar support. The Freer variant for this step is shorter and finer than the marginal-access blade, sized to take 2-3 mm of cartilage in millimetric increments.

The cephalic trim rule

A minimum 6 mm of caudal lower-lateral cartilage must remain after trim to support the alar rim; the surgeon measures the cartilage with a calliper before incising, and the Freer’s shorter blade prevents over-resection that the longer marginal knife would invite. The trim is bilateral and symmetric.

Why a knife rather than scissors

Scissors crush the cartilage edge and produce a healed margin that is visible on rhinoscopy; a sharp knife leaves a clean edge that heals invisibly. The Freer’s finer geometry preserves this advantage at the smallest working sizes.