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May 1987

Complications of External Rhinoplasty

Author Affiliations

New Orleans

Arch Otolaryngol Head Neck Surg. 1987;113(5):561. doi:10.1001/archotol.1987.01860050107033

To the Editor.—Having performed thousands of rhinoplasties, including about two thousand via the external approach, I find that the article by Burgess et al1 entitled "Complication of the External (Combination) Rhinoplasty Approach," which appeared in the October 1986 issue of the Archives, disturbing and feel that it cries out for comment.

First, the title is not semantically precise. A complication is a postoperative occurrence beyond the surgeon's control. Sequelae are the results of what the surgeon does during the operation. The photographic illustrations depict the results of inept surgery, not spontaneous occurrences.

Second, I have to wonder how much supervision these resident surgeons had and about the quality of that supervision. It is well known that in many programs the third-year resident teaches the second-year resident, and the second teaches the first; so the blind lead the blind and "mistake" clones are often produced. If it is granted

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