Push-down of the external nasal pyramid by resection of wedges

A technique of wedge resection is used for reduction of an extreme projection of the bony nasal pyramid. In these cases the push-down technique is inadequate, and resection of the dorsum is considered too destructive. The method consists of the resection under direct vision of a bony triangle at the base of the bony pyramid. To this end, a subperiosteal tunnel about 7-8 mm wide is created on the lateral and medial surface of the nasal bones via vestibular incisions.