Manual of Aesthetic Surgery 1 by Professor Dr. med. Dr. habil. Werner L. Mang (auth.)

By Professor Dr. med. Dr. habil. Werner L. Mang (auth.)

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5 cm from the medial canthus. • The detachment of the skin from the dorsum of the nose is carried out from both the right and left intracartilaginous incisions. Care must be taken to detach and remove all adhesions. In this manner complete mobilization of the skin on the dorsum of the no se can be achieved up to the giabella. • Subsequently, the periosteum of the nasal bone is pushed off with a sharp raspatory, bent on its blunt tip. Here again, the thumb and index finger of the surgeon's left hand serve as guide rails.

O c: cr::: :E • Using his or her right hand, the assisting surgeon p1aces the flat twopronged hook on the free margin of the nasal wing and pulls it upwards. Holding the 10ng two-pronged hook in his or her 1eft hand, the assisting surgeon pulls the co1umella toward the front. • The surgeon now has a good view of the anterior edge of the septa1 cartilage; using the number 15 sca1pel, he or she dissects the mucosa from the anterior edge of the septum, starting with the anterior nasal spine and continuing up to the nasal dome.

Nasolabial angle: 100-110 2. Mang's angle: 110-120 3. Glabellar angle: 12 degrees (women) 95-100 degrees (men) degrees (formed by the intersection of the nasal root-to-tip and nasal tip-to-chin lines) 35 degrees. The facial proportions are an important factor to be considered during planning of the septorhinoplasty. The no se should not be too large or dominant; neither should it be too small or doll-like. The art of aesthetic surgery lies in the creation of natural proportions. To achieve this goal, it is useful to divide the face into zones; for this purpose there are three horizontal zones and five vertical zones.

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