The nasal aponeurosis and its role in rhinoplasty.

Abstract

Much has been written about rhinoplasty since Joseph's monumental work. 1 Again and again new techniques have been described for shortening of the nose and the prevention of postoperative drooping of the tip. Because of the frequency of such reports and the fact that the proposed newer techniques were frequently offered without any basic reasons given for the changes, it appeared to us that some common ground could be found for explaining the advantages and disadvantages for the procedures advocated. For clinical reasons, it appeared to us that a study of the aponeurosis (fascia) of the nose might throw additional light on the subject, and lead to some standardized surgical procedure for shortening of the nose and a reasonable assurance that the lobule would remain in its elevated position long after operation. ANATOMY AND EMBRYOLOGY Only that part of the nasal aponeurosis which is attached to the pyriform margin of