Complications of the External (Combination) Rhinoplasty Approach

Abstract

\s=b\More rhinoplastic surgeons are using the external (combination) rhinoplasty approach for selected patients. Although several large series report few complications, the initial experience of newcomers may be different. A series of 26 external rhinoplasty approaches was examined, representing the initial experience of supervised residents. The most common complication was incising the anterior margin of the lower lateral cartilage at the juncture of the lateral and medial crura. To prevent this problem, it is recommended that the skin be elevated off the lower lateral cartilages from both a medial direction up over the domes and a lateral direction downward. To repair this complication, a figure-of-eight suture is used to reapproximate the incision.

Functional and Cosmetic Outcomes of External Approach Septoplasty

“…3 The transcolumellar incision involved has been cited as a disadvantage of the approach. 4 However, when correctly performed, the incision should cause minimal problems to the patient or the surgeon. 5 The external approach for septoplasty therefore has the potential to successfully and reliably treat the severely deviated nasal septum.…”

A New Technique for Use Instead of Lateral Crural Overlay for Reduction of Nasal Tip Projection in Revision Rhinoplasty

“…Although the approach to NTP is difficult in primary rhinoplasty, elevation of the LC from the nasal mucosa is difficult or even impossible in RR due to fibrotic scar tissue, tissue healing complications, deterioration of anatomical structures, and synechiae. Because the cartilage and the mucosa are not elevated in LCSE, fibrotic scar tissue does not represent a problem in the application of the technique ( 19 ). Moreover, the ease of the procedure allows for shorter surgery time compared to LCO.…”

Columellar Incision Scars in Asian Patients Undergoing Open Rhinoplasty

“…However, open rhinoplasty has several drawbacks, such as longer operation time, postoperative edema, and incision scarring. 3,4 A visible incision scar remains the biggest concern among rhinoplasty surgeons. Despite their clinical significance, incision scar problems after open rhinoplasty have not been discussed sufficiently.…”