Nasal correction in hyperteleorbitism. The short and the long nose

The soft tissue deformities associated with hyperteleorbitism often present serious reconstructive problems. Although skeletal correction is the basic preliminary step, the final result depends on the quality of the soft tissue and nasal repair. The patients are not interested in the postoperative intercanthal distance or the appearance of the X-ray film. What they want is a good aesthetic appearance and this is closely related to the shape and size of the nose. The short wide noses of the true hyperteleorbitism must be differentiated from the long noses associated with meningoencephalocele and pseudohypertelorism. For the first group, narrowing of the nose and the use of a forehead flap is indicated according to the severity of the problem. For the second group, shortening of the nose is accomplished by transverse resection of skin via a U shaped incision or skin replacement with a forehead flap. Downward sliding of forehead and brows may be necessary. The indication for each procedure is discussed and the different techniques are described.