Abstract
Both deviation and excessive width of the nasal dorsum result in conspicuous facial
disharmony and are often attended by nasal airway dysfunction. Whether the result
of developmental growth disturbances, nasal trauma, failed nasal surgery, or combinations
therein, deviation and splaying of the nasal dorsum can be exceedingly difficult to
treat. Individualized treatment is paramount because contour variations are seemingly
endless, and a careful preoperative assessment of the anatomic, physiologic, cosmetic,
and psychosocial factors that characterize the deformity is necessary to devise an
effective patient-specific treatment plan. Ensuring the linearity, strength, alignment,
and aesthetically pleasing profile dimensions of the nasal L-strut is the requisite
first step in successful treatment. Releasing all deformed components in a controlled
and precise manner using powered instrumentation (whenever possible) to facilitate
minimally traumatic and effective repositioning, followed by structural reconstitution
of the skeletal framework using autologous graft materials, and then consolidation
of the newly created construct with suture fixation completes the transformation to
normalcy. Paying equal attention to both cosmetic and functional wellness, while simultaneously
seeking to maximize structural stability, serves to optimize the final outcome.
Keywords
deviated dorsum - wide dorsum - L-strut - nasal axis - dorsal aesthetic lines
