Abstract
Managing the nasal septum position is crucial in septorhinoplasty. The analysis and the preparation of the anterior nasal spine and the quadrangular cartilage as well as the strategy defined to efficiently stabilize the septum will dictate considerably the success of the result. Moreover, what we see in the surgical table can suffer modifications during the healing process because of poor fixation or the cheese-wire effect of the cartilage. We will present a logical sequence and tools to achieve a proper and stable position of the nasal septum and the nasal pyramid. The sub-laminar (supra-perichondral) dissection of the quadrangular cartilage as an option to the sub-perichondral one and the use of cable and mirror sutures to three-dimensionally positioning and stabilizing the nasal septum will be described.
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