Deformity, etiology, solution, sequence (DESS): Facial analysis in rhinoplasty.

Purpose: Rhinoplasty is amongst the most challenging surgeries to perfect and can take decades. This process begins during residency; however, residents often have limited exposure to rhinoplasty during their training and lack a standardized method for systematically analyzing and formulating a surgical plan. The DESS (Deformity, Etiology, Solution, Sequence) is a novel educational format for residents that serves to increase their pre-operative comfort with the surgical evaluation and intraoperative planning for a rhinoplasty.

Alar retraction: etiology, treatment, and prevention.

Importance: The effect of different rhinoplasty maneuvers on alar retraction remains to be elucidated.

Objective: To determine the etiology and treatment of alar retraction based on a series of specific rhinoplasty maneuvers.

Design: Retrospective review of a single surgeon's rhinoplasty digital photo database, examining preoperative alar retraction from January 1, 2002, to December 31, 2005, in 520 patients.

Aesthetic repair of small to medium-sized nasal defects.

Reconstruction of small and medium-sized defects of the nose poses a challenge to the facial plastic surgeon. Flaps for small to medium-sized defects most often are closed in single-staged procedures as opposed to larger-sized defects. A variety of techniques can be used including secondary intention, primary closure, full-thickness skin grafts, composite grafts, rhomboid flaps, bilobe flaps, dorsal nasal flaps, island flaps, and inferiorly based meliolabial flaps.