Open rhinoplasty through a forked flap incision

Surgical elongation of the short columella is a challenging problem for the surgeon. Although some flaps from the upper lip are successfully used to c orrect this deformity on cleft lip patients with a scarred upper lip, these methods cannot be applied to noncleft patients with a smooth upper lip. Di stant flaps and composite grafts do not give the best aesthetic results. Th e use of an external approach for rhinoplasty is preferred by many surgeons , especially for difficult or secondary cases. Most incisions for open rhin oplasty are placed on the columella. This report describes a new incision f or open rhinoplasty to be used on patients with a short columella. The inci sion is a standard forked flap with a columellar base but the legs of the f lap extend to the nostril bases instead of to the upper lip. This method wa s used on eight aesthetic rhinoplasty patients with a short columella betwe en March 1995 and March 1998. The results of the method are discussed.