Challenges in Rhinoplasty.

Abstract

The art of rhinoplasty requires an in-depth understanding of both the function and the form of the nose. In primary rhinoplasty, rhinoplasty surgeons alter a patient's unique native nasal anatomy to create a nasal form that is perceived as more attractive by the patient without compromising the function of the nose. Alternatively, if the primary goal is to improve nasal function, this must be accomplished with negatively impacting appearance. Many challenges are presented to rhinoplasty surgeons to achieve the highest quality outcomes for their patients. This issue will focus on some of the most challenging aspects of rhinoplasty and nasal reconstruction. Readers will benefit from the expertise of the authors with decades of experience addressing specific technical challenges. Several articles will highlight advanced reconstructive techniques using novel interpretation of subunit principles and nasal valve support. Primary rhinoplasty can also have specific technical challenges in patients with specific anatomic subtypes. Understanding these challenges will help to prevent potential complications and will facilitate achieving superior aesthetic and functional surgical outcomes. Dorsal profile evaluation and management, the twisted nose, cleft nasal deformity, and alar contour will be specific areas of focus. Other articles will highlight the management of patients who have had previous nasal surgery to educate the reader on how to manage patients without adequate septal cartilage or that are functional or aesthetically devastated from previous nasal surgery.