THE SHORT NOSE

This article discusses the diagnosis and treatment of the short nose. Emphasis is placed on examining the short nose and on determining what particular features constitute an absolutely short nose versus an app arently short nose. The primary emphasis of the operation to achieve m aximum lengthening is based on (1) release of the soft tissue includin g the mucoperichondrium, which has to be elevated bilaterally from the septum; (2) release of the soft tissue between the upper lateral cart ilage and the lower lateral cartilage; and (3) attachment of a batten graft to the septum to project the tip cartilages caudally and to obta in a full centimeter of length. The closed technique (which prevents a dequate soft-tissue release of the mucoperichondrium of the septum) us es a hemitransfixion incision and elevation of the mucoperichondrium b ilaterally followed by attachment of a batten graft. Treatment for the apparently short nose, which involves derotating the tip, correcting the columellar labial angle, and altering the location of the nasion a s well as the slope (nasofacial angle), also is discussed.