This female patient underwent rhinoplasty for correction of a number of concerns. As seen on frontal projection: a wide asymmetric tip, deviation of the entire nose to the right, severe collapse of left middle vault, left alar retraction; as seen on lateral projection: long overprojected nose, dorsal convexity, and a hanging columella with inferior directed medial crura. Correction was accomplished via an open approach utilizing trancolumellar, marginal and intercartilaginous incisions. Surgical maneuvers included: septoplasty with elevation of bilateral lining flaps, placement of extended spreader grafts to brace the septum in the midline, dorsal reduction, lateral and medial osteotomies, a complete strip interdomal and intradomal sutures, septal shortening, and a tongue in groove maneuver. From: Fedok FG: Surgery of the Nasal Tip. In: Rusko J, Sataloff R, Sclafani A (eds.): Sataloff’s Comprehensive Textbook of Otolaryngology, Japypee Brothers Medical Publishers, Philadelphia, 2016.
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