Lengthening the short nose is one of the most difficult challenges in rhinoplasty. Etiologies for the development of a short nose include congenital, traumatic, iatrogenic (previous surgery), infectious, and granulomatous factors. Regardless of the cause, short nose correction requires the…
When it comes to the subject of rhinoplasty, many authors trivialize or overlook the role of nasal skin in cosmetic nasal surgery. Instead, interest is directed at the nasal skeleton and the various methods of modifying the underlying skeletal framework.…
Thin nasal skin readily reveals imperfections of the underlying osseocartilaginous framework and has profound implications for the surgical planning and execution of rhinoplasty. Thin skin may be a normal variant or the result of prior surgery, trauma, or disease. The…
Surgery of the lower third of the nose represents one of the most challenging aspects of rhinoplasty. The nasal tip is a three-dimensional structure described in terms of projection, rotation, length, and shape. Each of these components must be considered…
Reduction rhinoplasty has been the main objective for the majority of cosmetic rhinoplasties performed in Caucasians over many decades. Rhinoplasty experts today have a much better understanding of the intricate relationships between anatomic changes and rhinoplasty outcomes than previous generations…
A saddle nose deformity derives its name from the appearance of the nose on lateral view as the dorsal curve resembles the depression in a horse's saddle. The gross deficiency that exists in the dorsum of the nose, no matter…
General Considerations The crooked nose is neither a single entity nor a specific description. Crooked noses represent a spectrum of nasal deformities, most commonly of traumatic origin, that are associated with a deviated or irregular appearance to the nose. For…
Often unappreciated in rhinoplasty is the alar–columellar complex. Patients may present with a preexisting hanging or retracted columella or abnormal alar rim or columellar shape and configuration. In the patient with a preoperative normal relationship, certain surgical maneuvers, made to…
Older reduction tip rhinoplasty techniques are effective in altering tip contour and definition, yet they depend on aggressive cartilage resection, morselization, and sacrifice of tip supports to achieve these goals. Weakening of the crura in this manner, when subjected to…
The “pinched nasal tip” is a deformity caused primarily by collapse of the lateral crura of the lower lateral cartilages. Such collapse may be congenital due to inherent hypoplasia, weakening, or malposition of the cartilaginous support but is often secondary…