To correlate a surgical procedure with the results it achieves is, as a rule, not very difficult. Effects can be enumerated and benefits evaluated. But this presupposes that the surgery performed is predicated on a basic pathology concept and an established routine surgery technique and that the objectives sought are well understood and clearly defined.
In nasal surgery involving the external pyramid and septum, correlation is difficult because there are several technique concepts and no general agreement on diagnostic criteria. Also the surgical objectives, which can be considered under at least five different headings—cosmetic, esthetic, anatomic, psychologic, and physiologic—require recognition and definition to avoid adding confusion to an already involved problem.
The objective in cosmetic operations is to provide a change in appearance dictated by the demands and wishes of the patient.
Esthetic surgery imposes the additional objective of creating a change which is in harmony with other facial characteristics,