The nasal bony dorsum and cartilaginous vault. Pitfalls in management.

Our literature is replete with technical descriptions of rhinoplasty techniques designed to avoid certain complications. Analysis of 153 secondary rhinoplasties indicates that no procedure is immune to undesirable results and no specific technique can be employed to manage all potential problems. Critical scrutiny of these cases both preoperatively and intraoperatively indicated a decided recurrence of certain complications in the nasal bony dorsum and cartilaginous vault. Fifty-eight defects of the bony dorsum were encountered. These defects included open vault, wide dorsum, asymmetry, excessive or inadequate hump removal, abnormal nasofrontal angle, step deformities, and bony irregularities. Defects in the cartilaginous middle third of the nose occurred 91 times. These consisted to supratip prominence, valve collapse, asymmetry, and saddle deformity.