- Incisions
- Hump removal
- Nasal septum
- Tip narrowing
- The nasal bones
- Splint
- Tip support
- Shorten the nose
- The nasal spine
- Revision surgery
- The nasion
- Odd cartilages
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Rhinoplasty tutorial >> Incisions >> page 2
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We don't start with the
external incision, but rather with one of the internal incisions. The
pictures above demonstrate making the first incision. The left
image above shows initiating, and the right image completing, that opening
incision, which we
call the medial
marginal incision. A standard scalpel is used throughout the operation.
With my left hand, I'm twisting the tip of the patient's nose to her left, to stabilize the
nose and expose the place where I'd like to cut.
Most of the intra-operative pictures that you'll see on this site were taken from the perspective of where a right-handed surgeon stands: to the patient's right, about at chest level, with the patient's head elevated slightly on the operating bed. |
| Click on any image in this tutorial to see a greatly-enlarged version |
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Now I make the lateral
part of the marginal incision. The incision is called "marginal"
because it follows the margin of the nasal cartilage that gives the tip of the
nose its shape. The image above right shows the position of that cartilage
in blue, and I'm trying to hug its lower edge with the scalpel. You'll see the entire cartilage
as soon as we finish the incisions.
In medical lingo, "lateral" means "away from the middle," so this is the lateral part of the incision. The "medial" part of the incision, the part "closer to the middle," is the incision that hugged the side of the columella, pictured at the top of this page. |
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