The pioneers of early rhinoplasty In the late nineteenth and early twentieth century would take pleasure in the fact that this complex operation still Incorporates the fundamental principles Identified by these visionary men. It Is doubtful, however, that any among them could have foreseen the remarkable refinements rather routinely employed In the past decade.
Important developments have transformed aesthetic and reconstructive rhinoplasty from a procedure Incorporating primarily tissue reduction and sacrifice to one of tissue reorientation and reconstruction. Time and experience combine to teach that the finest and most natural long-term outcomes are those In which less removal of nasal structures Is effected, preserving natural form and function. Clearly the best rhinoplasty surgeons are those who think and plan long-term, tailoring the operation to the exact anatomy encountered, carrying out maneuvers designed to maintain control of the healing process. Cartilage grafting procedures, much more common now than in the past, lend unlimited possibilities to nasal contour sculpturing. Conservative preservation of the various components of the nasal framework and skin-subcutaneous tissue layer now reigns as a fundamental cardinal principle of modern rhinoplasty.