A New Approach to Surgery of the Lower Cartilaginous Vault

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Abstract
The new surgical concept and technique which I am presenting, is simple, rapid, and highly satisfactory in all types of deformities of the lower cartilaginous vault. In my experience it yields the greatest latitude for the best anatomic, physiologic, and harmonious configuration. Before describing this technique, it should be borne in mind that the sequence of the surgical procedures is of utmost importance for the proper correction of the deformities involved. Assuming that local infiltration and elevation of the soft structures have been completed with transfixion down to the nasal spine, the upper lateral cartilages are then freed from their attachments to the septum, thus avoiding trauma to them when surgery is performed on the dorsum. Shortening of the nose with the establishment of an approximate columella-labial angle is then completed prior to any surgery on the dorsum. The resulting release of the tip following this procedure allows it to
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