The transvestibular approach to the nasal tip and dorsum: a new refinement in rhinoplasty.

Abstract

The limited exposure of the lower lateral cartilage using the transcartilaginous approach may result in significant asymmetries in the nasal tip, especially in the region of the nasal domes and intermediate or middle crura. The author presents a new technique for exposing the lower lateral cartilage. Through a marginal incision, the whole endonasal surface of the lower lateral cartilage can be exposed, allowing the performance of different reduction and rearrangement techniques to the lateral and medial crura. The author discusses results of his experience using this new approach, emphasizing the surgical steps, advantages, and disadvantages. The transvestibular approach has proven to be a reliable approach that improves the predictability of endonasal rhinoplasty.