Practical Applications of Nasal Asymmetries in Rhinoplasty

Abstract

Comparing the bones that make up each side of the nose by anthropometry reveals asymmetries caused by both developmental and traumatic processes, which precludes performing osteotomies using a set procedure. The frontal process of the maxilla is a key structure in narrowing the bony contours of the nose to correct the “open roof syndrome” (incomplete closure of the roof of the nose) after hump removal. It must be included in many instances in order to achieve a satisfactory infracture. This is especially important in the management of a large or asymmetric frontal process. Furthermore, osteotomies should be placed sufficiently lateral to the nasal bones to prevent the aesthetically unpleasing complication of the so-called step deformity. The questionable efficacy of osteotomies in rhinoplasty on the non-Caucasian nose is also briefly considered in this article.