Planning for Rhinoplasty is very important because we aim for the results to be permanent and to improve the aesthetics. The aim of this surgery is both functional and cosmetic, firstly to improve the breathing and nasal airway but also to achieve a good result with aesthetic lines. One of the important contours that we are looking for is a gentle curve including the eyebrow down through the top of the nose which is the nasal dorsum, to the tip. This should be a gradual arch rather then coming out and in repetitively.
These days we like to fold the upper lateral cartilages in to add a little width to the middle of the dorsum. This can be done with a spreader flap or spreader graft. The upper lateral cartilages are in turned, making this area a little wider to blend to the contour of the gradual arch we are looking for. Traditional surgery cuts across these cartilages creating an inverted V deformity and breathing problems. When we retain the upper lateral cartilages and fold them in the breathing is better and the contour is much improved. Having the slight increase in width across the middle of the nose adds to the aesthetics as shown in this before and after photograph.