THE NASAL HINGE

It is generally agreed that rhinoplasty is the most challenging proced ure performed by the facial plastic surgeon. Mastery of nasal tip mane uvers to alter tip projection, rotation, and lobule refinement is intr insic to successful rhinoplasty technique. The nasal hinge region comp rises the most lateral aspect of the lower lateral cartilage. Its impo rtance is often overlooked. As the foundation of the nasal base, it pl ays a key role in tip dynamics and can be sculpted to significantly mo dify projection, rotation, and lobule refinement. One hundred randomly selected rhinoplasty patients were studied with respect to the indica tions for hinge maneuvers, techniques applied, and resulting affect on tip aesthetics. Clinical results are shown. The applicability of thes e hinge techniques is compared with other lateral crural techniques. T he importance of the hinge region in rhinoplasty dynamics and the nece ssity of knowledgeably applying surgical maneuvers in this region are discussed.