Owing to modification of the surgeon's views and his enlarging experience, rhinoplasty, like any applied art, is subject to change. The rhinologist of the past, as a result of long trial-and-error experience, learned empirically the conditions for a successful rhinoplasty, but not the underlying principle. Thus he was unable to cope with unexpected perplexities, such as postoperative drooping of the tip, broadening, pinched "surgical" appearance, asymmetries, and cicatricial distortions. Without the proper concept, correction was attempted by this or that maneuver. The countless procedures recommended1 added to the confusion of the novice and did not help the experienced operator, who had developed through the years a personalized method and was not likely to accept a suggested innovation in which he could not personally foretell the probable outcome.
The following remarks are addressed to the beginner, in an attempt to replace past complicated techniques with present simpler procedures.
FOMON S, LUBART J, BELL JW, SCHATTNER A, SYRACUSE VR. Rhinoplasty, Past and Present. AMA Arch Otolaryngol. 1958;68(4):426–432. doi:10.1001/archotol.1958.00730020440004