En bloc nasal shift rhinoplasty--an approach to the small crooked nose.

Correction of the crooked nasal pyramid without reduction of nasal size is difficult using customary techniques. In the small nose without need for hump removal, the bony portion of the external nose can be shifted centrally after nasomaxillary and frontonasal osteotomies have been done. The correction is maintained either by appropriate resection of the long nasal bone at the nasomaxillary osteotomy or by blocking the short nasal bone forward with a graft in the nasomaxillary osteotomy. The technique is useful in the occasional septorhinoplasty in which nasal size should be preserved.