[Rigid fixation to prevent iatrogenic septal deviation]

This and similar studies show that surgeons can not rely on the immediate effect of scoring on the cartilage at the operation period. A straight septum on the operating table may deviate toward the opposite side by passing time. During a period of 5 years, 283 cases have undergone rhinoplasty and in 227 patients, septoplasty accompanied the operation. Patients were divided into two groups of 125 and 158 cases. In the first group, septal deviation was corrected mainly by cross hatching of the quadrilateral cartilage accompanied by other modalities. In latter group, who were operated on recently, different methods of rigid fixation of septum in addition to the previous classic manner were used. The outcome was over correction of septum toward the opposite side in 18 cases of the first group. No more iatrogenic over correction of septum was diagnosed in the second group, [P<0.0001]. We recommend rigid fixation for correction of septal deviation instead of simple cross notching

[Thick nasal skin 4 years experience with a proposed technique]

Soft tissue thickness over the tip of the nose varies considerably between patients, subcutaneous fat being thickest in the supratip area. Fat nose is a challenging issue to manage, and surgeons have not found the ultimate solution to handle this problem during the evolution of rhinoplastic surgery. Due to multiplicity of techniques and controversies published in literature, it becomes confusing for the operating surgeon to find the most appropriate and effective way of solving this frustrating dilemma. The focus of this paper is to introduce a new procedure for reducing the overlying soft tissue of nasal tip for better re-draping of skin over the nasal skeleton. The hallmark of this technique is to undermine the nasal skin in two layers. We believe that soft tissue trimming in biplane dissection, described in the paper, can minimize the thickness of the tip skin in a safe and homogenous manner. In this paper we have demonstrated a new dissection method of nasal soft tissue and trimming it in different areas of the nose for different purposes. In the authors' opinion this approach is one of the most effective way of handling unpliable thick nasal skin