ABSTRACT
The nose is a complex three-dimensional structure with a multiple-layer anatomy which must be evaluated before doing a nasal correction. In the upper third, the skin is thick and relatively distensible. It then tapers, becoming tightly adherent to the osteocartilaginous framework, thinning towards the dorsal nasal bridge. The middle third overlying the nasal bridge has the thinnest, most adherent, and least distensible skin. The nose consists of a framework of skin, cartilage, and bone with six distinguishable layers: skin, superficial fatty layer, fibromuscular layer, deep fatty layer, periosteum, perichondrium, and bone cartilage. The nasal SMAS is a continuation of the facial SMAS. This layer unsheathes the muscles and is highly vascular. The skeletal component of the nose consists of bone and cartilage. The cartilaginous nasal frame consists of a pair of upper and lower lateral cartilages and the nasal septum. The upper lateral cartilages are paired rectangular cartilages that support the lateral nasal walls.
