ABSTRACT
Nasal trauma is the most frequent facial injury. The post-traumatic situation creates a significant disharmony of proportion: twisted and angulated noses upset the flowing line from the supraorbital rim to the tip of the nose, as does an avulsed or depressed upper lateral cartilage (ULC), a deviated dorsal cartilaginous septum or an asymmetric alar–cartilage complex. Those patients who sustain sufficient nasal trauma and require relatively acute nasal reconstruction and rhinoplasty compose a different category of patients presenting for nasal cosmetic surgery. Cephalometric and lateral 'soft tissue' RX examination is used to measure tip rotation (TR) and tip projection (TP). Primary post-traumatic surgery is limited to symptomatic treatment of haemorrhage and reduction of major dislocations. In general, the reconstruction is planned 6–12 months after the injury or the primary repair, at the time of maturation of scar tissue and stable deformity. A significant post-traumatic deviation of the external pyramid is practically always accompanied by a deviated septum.
