ABSTRACT
Advanced rhinoplasty encompasses a wide range of rhinoplasty techniques and challenges. However, much of what is considered within the scope of advanced rhinoplasty relates to the diagnostic and therapeutic methods used in revision rhinoplasty. Advanced rhinoplasty has been considered synonymous with revision rhinoplasty, but this notion has changed over the last 20 years. Revision techniques are now being applied routinely to primary cases under the guise of ‘augmentation rhinoplasty.’ Revision rhinoplasty usually involves reconstitution of lost cartilage and bone and reconstruction of the nasal framework. This approach, when applied to patients undergoing primary rhinoplasty, is termed augmentation rhinoplasty. Augmentation of the nasal framework in primary rhinoplasty has come to be favored over radical cartilage excision and destruction because the former achieves a more stable and natural-appearing long-term result. What is included under the general heading of ‘‘advanced’’ is sometimes arbitrary. Nevertheless, this chapter will include a review of revision rhinoplasty, augmentation rhinoplasty including grafts and implants, the open rhinoplasty technique, and challenging special conditions including lengthening a short nose, straightening a crooked nose, cleft rhinoplasty, rhinoplasty in the aging patient, rhinoplasty in nonwhite patients, and repair of nasal fractures.
