[External transcolumellar approach and cartilage grafting: a very complementary association]

Two major facts have modified the philosophy of rhinoplasty: the desire to obtain more harmonious and balanced nose with conservative resections and a more frequent use of the open approach. This approach allows more accuracy in the diagnosis of the deformities and in the control and the preservation of the supports of the nose, namely the tip, alar and middle vault supports, and in the use of innovative techniques, specifically in the nasal tip: suture techniques and cartilage grafts. External transcolumellar approach and cartilage grafting go hand in hand and are frequently associated in the correction of under and overtip projection. Grafts can be use for improvement of aesthetic and function and the excellent exposure provided by the open approach permits a precise placement and stabilization of the grafts. Septal surgery benefits significantly from the excellent exposure for correction of all kind of deformities.