The Precision of Template Rhinoplasty

Objective: To determine a new stable nose profile

• Calculate soft tissue changes that control the tip tripod position
• Add a dorsal reduction that matches the tip
• Make a template to gauge the changes

Closed rhinoplasty preferred

• Better skin control because tip skin moves with the tip skeleton
• Can safely detach soft tissue from the whole of the pyramid and move it back towards the narrowed pyramid base
• Greater nasal reductions are possible compared with open rhinoplasty

Operative procedure

• Inject beneath the elastic cuff and release it from the caudal margin
• Inter-cartilaginous or supra-cartilaginous incisions extend to pyriform margins
• Shorten lateral alar ligaments
• Totally release soft tissue from pyramid
• Low to osteotomies and in-fracture
• Bone grafts into osteotomies
• Reattach elastic cuff
• Kaltostat pack for 2 days
• Aquaplast splint for 6-8 days then wear splint at night for up to 6 weeks