New data in the correction of twisted noses.

Besides the numerous functional difficulties for the patient with a twisted nose, he must also handle its psychological repercussions. These repercussions are the cause of the frequent demands for purely aesthetic surgery. Correcting the twisted nose is difficult. There are the possible cutaneous adhesions. Also, two classical factors are involved: septal, due to the elasticity of the cartilage; and the bone itself, due to ostectomies and/or osteotomies not performed or done incorrectly. Though the elasticity of the septal cartilage is corrected by many surgeons, few of them modify that of the alar cartilage. This is what we discuss in this article. We also discuss another element of major importance, the periosteum and its inextensibility.