HEAD AND NECK

1. Preoperative view of the nose.

2. Preoperative view of the nose.

3. Planning the operation.

4. Planning the operation.

5. Injection of local anesthetic and vasoconstrictor.

6. Incision at the junction of the skin with the mucosa.

7. Extending the incision to the mucosa of the left nasal chamber.

8. Incision for the dissection of the right upper lateral cartilage.

9. Unification of the incisions for the quadrangular and the upper lower cartilage.

10. Incision for the left upper lateral cartilage.

11. Unification of the incisions also in the left nasal chamber.

12. Dissection of the upper lateral cartilage with scissors.

13. After the dissection of also the left upper lateral cartilage, the skin of the nose is fully elevated from its cartilaginous framework.

14. Elevation of the skin from osseous framework also.

15. View of the nose with an endoscope. The elevated skin and the upper lateral cartilages below are seen.

16. Cutting the right upper lateral.

17. Cutting the right upper lateral. Another view.

18. Repeating the procedure on the left side..

19. Grasping the quadrangular cartilage with forceps.

20. Cutting the upper edge of the quadrangular cartilage with scissors.

21. The reduction of the height of the quadrangular as compared to the laterals.

22. Grasping and cutting the upper laterals.

23. The effect of cutting the cartilages on the appearance of the nose.

24. Removing the osseous hump with a chisel.

25. Cutting the lower laterals to reduce the bulk of the tip of the nose.

26. External osteotomies.

27. The final appearance of the nose.

28. Fitting the plaster.