External rhinoplasty approach for repair of posttraumatic nasal deformity

Up to 50% of patients who have suffered a nasal fracture may seek reconstructive surgery because they are dissatisfied with their appearance and/or ability to breathe. Distortion of native anatomy and dissection planes increases with severity of the injury. The external rhinoplasty approach is a biologically sound technique that offers several advantages over endonasal access for the repair of complex nasal deformities. In 30 consecutive posttraumatic rhinoplasty cases over a 2-year period, 27 (90%) patients underwent correction of their deformities via the external rhinoplasty approach. No technique-specific sequelae were encountered, and all patients were satisfied with their respective result and the healing of the transcolumellar incision. This article reviews the advantages, disadvantages, and contraindications of the external rhinoplasty approach in the posttraumatic patient.