Anatomical Approach to Rhinoplasty Herve LeBoeuf, MD Faculty Advisor: Karen Calhoun, MD The University of Texas Medical Branch Department of Otolaryngology Grand Rounds Presentation January 2001 Which Incision ?? Transfixion/Hemitransfixion Caudal septum, medial crura, nasal spine  Just caudal to septum  Follows medial crura to flared ends  Extend to floor for tip projection access  Hemi- is unilateral only  – Avoids disruption of tip support – Poorer access, ? Asymmetric healing Intercartilaginous Incision Access to the tip and mid-nose  Incision intranasal, between the  ULC/LLC Begin medially as transfixion extension  Continue entire length of LLC  Avoid transecting the lateral end of the  LLC