Jérome Paris, MD Institut Euro Méditerranéen de Chirurgie Plastique & esthétique 13, rue Roux de Brignoles 13006 Marseille FRANCE Mail contact: paris.J@wanadoo.fr Website: www.iemcep.com
Rhinoplasty surgical procedure is one of the most interesting and complex aesthetic surgical procedure… proved by the number of secondary rhinoplasties. The main goal of aesthetic and artistic rhinoplasty is to achieve a natural look of beauty enhancement and most harmonious face. There is no one standart rhinoplasty but many rhinoplasties that have to suit to each patient. Quest of beauty is everyone demand for a better well being and self confidence. Rhinoplasty has to improve facial aesthetics and to improve nasal breathing function which is also an important point for patients.
M. Laurent Castillo, MD Professor of Clinical Otolaryngology – Head and neck surgery Head and neck institute
M. Charles Savoldelli, MD Fellow of Oral and Maxillofacial surgery University of Nice Sophia-Antipolis, France Head and neck institute
The internal approach in rhinoplasty requires a surgical experience and an artistic perspective to provide adequate results on nasal deformities. The external approach allows cartilage shaping and grafting through a wider exposition of the entire nasal structure (bones and cartilages), but leaves a columellar scar. The wide marginal approach is known as open rhinoplasty without skin-columella incision. It was first described by guerrerosantos  in 1987. This procedure was originally introduced to lessen the complications seen with the open approach, while keeping the advantages of a better exposition insufficient with closed rhinoplasties. Although scarcely discussed in the literature, this approach can be proposed to a patient refusing the open approach when needed to address difficult tips.