This is a review of the muscular anatomy of the nose. Areas of inconsi
stency in the main anatomy texts are high-lighted and concentrate part
icularly on the omission of three identifiable muscles from modern tex
tbooks. Two topographical areas of the nose in need of further anatomi
cal development are identified. In a sample of 121 subjects from the g
eneral population, 40% were found to be incapable of flaring the nostr
ils voluntarily or subconsciously in conjunction with energetic inspir
ation with the mouth closed. The authors recommend systematic clinical
assessment of the nasal musculature be incorporated in the pre- and p
ostoperative examination of the rhinoplasty patient. The division of t
he nose into five sections for assessment is proposed and the muscles
contributing to each area are defined together with their individual s
urgical relevance.