A Practical Approach to Rhinoplasty

Overview

Rhinoplasty remains one of the most commonly performed cosmetic operations, and the open approach has grown in popularity over the previous 25 years. The authors state five principles behind a successful operation and then discuss techniques for each region of the nose that in their experience give consistent results.

Sections of note

• The article is a review, not a study of patients, and focuses on the open approach.
• Five stated principles: comprehensive clinical analysis with defined goals, preoperative consultation and planning, precise operative execution, postoperative management, and critical analysis of one's own results.
• Systematic nasal analysis is described as critical to establishing what the surgery should achieve.
• Techniques are discussed for the nasal dorsum, the nasal airway, the tip complex, the alar rims and the bony vault.
• The stated criterion for including a technique is that it provides consistent results.
• No patient numbers, complication rates, revision rates or outcome data appear in the abstract.

What it means for a patient

• Analysis and planning are treated as equal in weight to the operation itself, which is why consultations for rhinoplasty are longer than for many procedures.
• The airway is listed alongside the appearance regions, so breathing is part of the standard plan rather than a separate concern.
• Reviewing one's own results critically is included as a principle, which reflects how much of rhinoplasty technique comes from surgeons auditing their own outcomes.
• A narrative review with no data cannot show which techniques produce the most consistent results.

Why this paper matters

Practical overviews from high-volume surgeons shape how the operation is taught and what is considered routine. Structuring rhinoplasty as a five-stage process, rather than a set of manoeuvres, is the framing offered here. What such an article cannot do is provide evidence that the recommended techniques outperform alternatives.

Terms

• Open approach: rhinoplasty using a small external incision across the columella to lift the skin.
• Nasal dorsum: the bridge of the nose.
• Tip complex: the cartilages and soft tissue forming the nasal tip.
• Alar rim: the edge of the nostril.
• Bony vault: the upper third of the nose, formed by the paired nasal bones.
• Nasal analysis: systematic assessment of nasal proportions and landmarks before surgery.