Dorsal Approach Rhinoplasty

Direct dorsal excision of skin and subcutaneous tissue is employed in rhinoplasty cases characterized by thick rigid skin to achieve satisfactory esthetic results, in which attempted repair by more conventional means would most likely frustrate both surgeon and patient. This historical review reminds us of the lesson: ‘History repeats itself.’ Built on a foundation of reconstructive rhinoplasty, modern cosmetic and corrective rhinoplasty have seen the parallel development of both open and closed techniques as ‘new’ methods are introduced and reintroduced again. It is from the perspective of constant evolution in the art of rhinoplasty surgery that the author presents, in Part II, his unique ‘eagle wing’ chevron incision technique of dorsal approach rhinoplasty, to overcome the problems posed by the rigid skin nose.