Abstract

IT WAS Joseph 1 who first described the surprising alteration of facial expression after treatment according to the principles of nasal plastic surgery. He depicted the subjects of plastic surgery dancing in a happy mood, and it was his belief that the newly acquired state of satisfaction was mainly psychologic, due to the absence of the previous nasal disfigurement. Some of my patients who were treated by nasal plastic surgery without anything else showed such a remarkable spontaneous improvement in their entire countenance that the question could be asked whether this change of facial expression was actually caused only by psychologic uplift. Or is it possible that nasal surgery alone can effect indirectly changes of facial expression? To answer this question, I undertook the following study. Figure 1 shows the same patient before and after nasal repair. The second picture was taken seven weeks after the first. The preoperative diagnosis was:

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