General Principles Maintaining or achieving structural integrity of the nasal form is a formidable task in rhinoplasty and nasal reconstruction. Maintaining the form and function of the nose is an equally important objective as creating a pleasing aesthetic contour. In…
In 1898, Jacques Joseph was one of the first surgeons to promote the concept of the nasal osteotomy as a way to reshape and reposition the bony vault. The primary indications for osteotomies are to straighten a deviated nasal dorsum,…
The nationally reported revision rate for primary rhinoplasty ranges from 8% to 15%. Unfortunately, there will likely never be a shortage of patients requiring revision rhinoplasty. Experienced surgeons consistently achieve a high level of satisfaction among their patients. Still, complications…
Rhinoplasty is one of the most challenging operations in plastic surgery. The three-dimensional nature of the nose, conformed by skin and soft tissue envelope (S-STE), and the shape and orientation of the nasal cartilages and bones are variables that, when…
The incidence of postoperative nasal deformities requiring secondary rhinoplasty varies from 5% to 12%. The etiologies of postoperative nasal deformities ( Table 7-1 ) are usually related to one or any combination of the following three problems: (1) displacement or distortion…
Surgical refinement of the nasal tip is considered by many to be one of the most challenging components of rhinoplasty. At the heart of the challenge is the need to not only adequately access and visualize but also control the…
Primum non nocere The first goal during rhinoplasty, as with all other aspects of medicine and surgery, is to do no harm, and it pertains to both nasal function and aesthetics. Moreover, every rhinoplasty patient will present with a set…
Starting a practice in cosmetic facial surgery is daunting. Every new facial plastic surgeon is eager to make his or her mark and to put into practice his or her numerous years of training, although, in truth, the real education…
Introduction Nasal analysis in the setting of the preoperative consultation is undoubtedly one of the most critical elements of the rhinoplasty process. This is the time in which the patient and surgeon communicate expectations, build rapport, and mutually decide whether…
Rhinoplasty surgery requires a robust understanding of the surgical anatomy and physiology of the nose and nasal airway. Only by building on this solid foundation can a rhinoplasty surgeon adjust and tailor surgical techniques to fit unique individual patient needs.…