Rhinoplasty5 pearls: value of the endonasal approach and vertical dome division.

Successful outcomes in rhinoplasty depend more on diagnosis than on approach or technique. When the needs of each patient are assessed on multiple occasions, operative performance improves and revision rates decline. The evolutionary track from an endonasal and excisional operation to the more commonly preferred external and restructuring technique is outlined in this article.

Hockey-stick vertical dome division technique for overprojected and broad nasal tips.

Objectives: To discuss overprojected and broad nasal tips, to overview treatment options, and to relate our experience with the hockey-stick technique.

Design: A retrospective review (1975-2005) was conducted. Patients were selected from a computerized rhinoplasty database of operative cases.

Rhinoplasty in male patients.

The complexities of rhinoplasty are further emphasized when this operation is undertaken in the male patient, and a growing percentage of the rhinoplasty population comprises men. We review the senior author's approach to rhinoplasty analysis, preoperative consultation, and surgical techniques that have been successfully employed for over 40 years. Specific recommendations and modifications to these techniques are discussed as they relate to the rhinoplasty operation in male patients.

Caudal septoplasty for treatment of septal deviation: aesthetic and functional correction of the nasal base.

Objectives: To describe our technique in the treatment of significant caudal septal deviation; to evaluate the effectiveness of our technique of caudal septoplasty in the treatment of caudal septal deviations.

Design: Retrospective review of cases taken from a database of more than 2000 patients who underwent rhinoplasty performed by 1 surgeon in a private facial plastic surgery practice.

Results: Medical charts were reviewed to determine the rate of preoperative nasal obstruction in 59 (95%) of 62 patients as well as nasal obstruction postoperatively 11 (17%) of 62 (P < .

Evaluation of the Goldman tip procedure in modern-day rhinoplasty.

Objectives: To present a critical review of a single surgeon's long-term results using the Goldman tip procedure and to examine the current attitudes of a select group of experienced rhinoplasty surgeons concerning the Goldman tip procedure.

Design: A retrospective review was conducted of the medical records of all patients who underwent a Goldman tip procedure performed by the senior author (R.L.

A personal report: emphasizing the endonasal approach.

The beauty and allure of rhinoplasty rests in its unending mystery of challenges. It is an operation that demands the surgeon's attention, and it is a procedure in which technical skill alone seldom assures successful outcomes. Following a 40-year involvement with rhinoplasty, the author awaits his next case with as much enthusiasm as the first.