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External septorhinoplasty: A tool for teaching and for improved results

The external septorhinoplasty incision is basically a 5 mm. incision across the columella connecting a left and right alar margin incision. This allows retraction of the dorsal skin to expose the entire dorsal skeletal structure. It has great advantage to both surgeon and assistant for teaching and studying deformed nasal anatomy, and for improved rhinoplasty results because it allows binocular visual monitoring of surgery, the use of both hands, control of bleeding by electrocautery, accurate diagnosis of revisional surgery, and the use of permanent sutures to fix and approximate the various surgically modified nasal structures so that postoperative distortion from healing does not occur. If grafts or implants are needed they can be accurately modelled and sutured in place to prevent postoperative wobbling. The columellar scar if properly closed becomes inconspicuous in a few months, and even early in the healing process it is not noticed because the observer is viewing it at a very oblique angle. It is felt that this operation will be a very valuable addition to everyone doing rhinoplasties and septoplasties.