[External rhinoplasty: a useful approach for a young plastic surgeon]

Among the frequently performed plastic surgery operations, rhinoplasty is the most difficult to obtain consistently good results. It is very challenging for young plastic surgeons to modify the external appearance of the nose and restore or maintain a good airway. The external approach has alleviated some of the problems due to understanding and learning of the rhinoplasty operation. Actually, open rhinoplasty allows better visualization of anatomical deformities and better manipulation of tissues allowing better integration of nasal anatomy and physiology. This paper reviews a personal series of 82 patients operated via an open approach between October 94 and October 97. During the same period, 24 patients were operated via an endonasal or percutaneous approach (osteotomies). Indications, advantages and disadvantages of the open approach are discussed. The various techniques used in this series are described and then critically analyzed. In open rhinoplasty, our present revision rate is 8.5%. In conclusion, the open approach seems to be useful for young rhinoplastic surgeons.