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The Importance of the Anterior Septal Angle in the Open Dorsal Approach to Rhinoplasty

Rohrich, Rod J. M.D.; Dauwe, Phillip B. M.D.; Pulikkottil, Benson J. M.D.; Pezeshk, Ronnie A. M.D.

Plastic and Reconstructive Surgery: March 2017 - Volume 139 - Issue 3 - p 604–612
doi: 10.1097/PRS.0000000000003123
Cosmetic: Special Topic

Summary: Functional and aesthetic manipulation of the nose relies on a detailed understanding of nasal anatomy and a meticulous dissection. Maneuvers are performed in four regions of the nose: nasal tip, dorsum, posterior septum, and caudal septum. Positioned at the cornerstone of these regions, the anterior septal angle acts as a point of reference, especially in secondary rhinoplasty. Identification of the anterior septal angle early in the nasal dissection aids in reliable exposure, either wide or limited, and facilitates desired maneuvers. In addition, alteration of the position of the anterior septal angle can affect nasal tip projection, especially in cases such as the tension tip deformity. The authors emphasize the importance of the anterior septal angle in their simplified methodology for the open dorsal approach in rhinoplasty.

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Dallas, Texas

From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.

Received for publication May 12, 2015; accepted June 21, 2016.

Disclosure: The authors have no financial interests in this research project or in any of the techniques or equipment used in this study. Dr. Rohrich receives instrument royalties from Eriem Surgical, Inc., and book royalties from Taylor and Francis Publishing. No funding was received for this article.

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Rod J. Rohrich, M.D., Dallas Plastic Surgery Institute, 9101 N Central Expressway, Suite 600, Dallas, Texas 75231,

©2017American Society of Plastic Surgeons