A conservative approach to rhinoplasty.

When a rhinoplasty is performed, one must keep in mind that the nose is a part of a whole structure, the face. In the ideal nose operation all the components of the nose are well balanced among themselves and the nose itself is a harmonic part of the face. The present article briefly reports on how the different excisions of a rhinoplasty should be done to get a well-balanced nose. The objective of the presentation is to emphasize how only a very small amount of osteocartilaginous framework can be removed to obtain a very satisfactory result. The most caudal portion of the septum is almost never removed and the tip elevation is achieved with a logical excision of both lower and upper lateral cartilages. Wedges from the alae are seldom excised, producing a more natural looking nose. In summary, we try to achieve better appearing noses that do not look operated on.