Correction of the Bony Rings During the Aesthetic Rhinoplasty: Apologia of the Transpalpebral Osteotomy

Abstract

It is observed that in many cases of rhinoplasty, the final aesthetic result on the face of patients was not satisfactory. The reason is the persistence of ``rings'' making a shadow beside the root of the nose. These ``rings'' seem to be palpebral but are actually made by the frontal process of the maxilla. Osteotomy in rhinoplasties classically involve the nasal bones. However, the osteotomy in our cases is made on the frontal process of the maxilla. This surgical refinement is detailed with regard to a minute palpebral incision, precisely placing the lateral osteotomy on each frontal process of the maxilla, in-fracture and rasping equally. While the osteotomy procedure is well documented in rhinoplasties, the improvement of the patients' final appearance at the root of the nose after rhinoplasty is less clearly established. This report will detail an innovation based on the author's 15-year surgical experience with primary and secondary rhinoplasty. The improved result is remarkable on the final appearance of the nose. Close-up photography demonstrates the anatomy as well as the technique.