Facial Plast Surg 2021; 37(01): 002-011
DOI: 10.1055/s-0041-1723825
Original Article

Rhinoplasty Dissection Planes (Subcutaneous, Sub-SMAS, Supra-perichondral, and Sub-perichondral) and Soft Tissues Management

José Carlos Neves
1  Department of Facial Plastic Surgery, Myface Clinic, Lisboa, Portugal
,
Vitaly Zholtikov
2  Department of Plastic Surgery, St. Petersburg State Pediatric Medical University, Saint Petersburg, Russian Federation
,
Baris Cakir
3  Department of Plastic Surgery Private Practice, Terrace Fulya, Hakkı Yeten Cad., Istanbul, Turkey
,
Erhan Coşkun
4  Department of Plastic Surgery, Abdi İpekçi Caddesi No.53 Side Apartmanı, Istanbul, Turkey
,
Diego Arancibia-Tagle
5  Department of Otolaryngology and Head and Neck Surgery, Hospital Universitari Son Espases, Secretaria Otorrinolaringologia, Palma de Mallorca, Baleares, Spain
› Author Affiliations

Abstract

Rhinoplasty as an operation is akin to a game of chess, where every maneuver will influence the eventual outcome. Undoubtedly, more than one approach to the nasal soft tissues envelop can produce beautiful and safe results as will be described in the paper namely, the subcutaneous, sub-superficial musculoaponeurotic system, supra- and sub-perichondral planes. For different justifiable reasons surgeons have their preferences, regarding dissection planes on the tip, middle and upper thirds, and regarding the manipulation of the soft tissue layers and nasal ligaments. The concept of the nasal layers and the presence of relevant ligamentous structures and how to restore them in an anatomical fashion, will help to understand the logic behind various approaches.



Publication History

Publication Date:
25 February 2021 (online)

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