ABSTRACT
Rhinoplasty is the most frequently requested aesthetic procedure usually directed towards reduction, augmentation or subtle refinement of the bony-cartilaginous skeleton. The skin soft-tissue envelope (SSTE) redrapes to its new foundation. Many components of the operation can be variably affected by the healing process. The philosophy is preservation, reconstruction and cartilaginous grafting, providing tip support and creating a strong, high profile that provides and maintains the shape to the overlying SSTE by opposing the distorting scar contracture, and preserving or correcting the nasal airway. In the transcartilaginous approach, the amount of cephalic resection of the lower lateral cartilage is determinated pre-operatively, before the through nasal skin and cartilage incision. The standard approach is intranasal after stab incision and tunnelling, or directly through the mucosa, at the pyriform rim just superior to the inferior turbinate, respecting the valve area at Webster's triangle.
