Rhinoplasty

The nose is a complex three-dimensional structure with critical structural and functional roles; its relationship to surrounding structures is, in part, responsible for a harmonious, pleasing visage as a whole. There are many variables and dimensions that can be adjusted to alter the aesthetic appearance, structural components, and functional role of the nose and many tools and maneuvers available to the rhinoplasty surgeon to adjust these numerous variables. Although every rhinoplasty operation should be individualized, a systematic approach and algorithm are helpful in operative planning as well as establishing a logical progression of steps and maintaining stability. While each adjustment may have a primary anticipated effect, it will invariably have secondary influence. The astute nasal surgeon should be aware of these dynamics in planning for rhinoplasty in order to anticipate the most effective maneuver for a specific patient’s anatomy, during surgery to make appropriate adjustments as needed, and postoperatively to assess their results. Male rhinoplasty requires its own considerations which will be discussed in this chapter.