The Importance of the Anterior Septal Angle in the Open Dorsal Approach to Rhinoplasty

Overview

Rhinoplasty maneuvers happen in four regions: the tip, the bridge, the back part of the septum, and its front edge. The anterior septal angle sits where those regions meet. This paper describes finding it early and using it as a reference point, within the authors' simplified method for the open dorsal approach.

Sections of note

• Maneuvers are described as taking place in four regions: nasal tip, dorsum, posterior septum, and caudal septum.
• The anterior septal angle is positioned at the cornerstone of these four regions.
• It acts as a point of reference, described as especially valuable in secondary rhinoplasty.
• Identifying it early in the dissection is said to aid reliable exposure, whether that exposure is wide or limited.
• Altering the position of the anterior septal angle can affect nasal tip projection.
• Tension tip deformity is given as a specific case where that applies.
• The article is a technique and anatomy description with no patient numbers, outcomes, or follow-up reported.

What it means for a patient

• The operation is organized around anatomical landmarks rather than performed freehand.
• In a revision, where earlier surgery has changed the anatomy, a reliable landmark matters more because the usual reference points may be gone.
• Tip projection can be adjusted by repositioning this part of the septum, not only by adding grafts.
• This is an expert technique article with no measured results, so it does not show that the approach improves outcomes.

Why this paper matters

Consistent landmarks make a highly variable operation more repeatable and safer to teach. The anterior septal angle links the tip and the bridge, so decisions there affect both. The paper reports no data on whether the described method reduces complications or revisions.

Terms

• Anterior septal angle: The forward upper corner of the septum, just beneath the area above the tip.
• Dorsum: The bridge of the nose.
• Caudal septum: The front lower edge of the septum, behind the columella.
• Secondary rhinoplasty: An operation on a nose that has already been operated on.
• Tension tip deformity: A nose whose tip is pushed forward and stretched by an overly tall septum.