The authors describe horizontal skin excision and vertical midline skin excision with case reports of vertical skin excision in difficult revision rhinoplasty cases.1 The results of the cases are exceptional, and such results could probably not have been achieved without the direct skin excision. Dermabrasion was described in three of the four examples presented.
See also p 542.
The concept of horizontal dorsal skin excision has been around a long time and has been the target of some misunderstanding. It should be understood that horizontal dorsal skin excision alone will not have much of a lasting effect in lifting a drooping nose, either as a primary or as a secondary sole rhinoplastic maneuver. It is only when the skeletal elements have been properly readjusted and the skin has been undermined that skin excision will have a significant effect. Personal experience with three cases of secondary rhinoplasty (performed in aging
Quatela VC, Sherris DA, Johnson CM, Kabaker SS. Skin Excision Revision Rhinoplasty. Arch Otolaryngol Head Neck Surg. 1993;119(5):547. doi:10.1001/archotol.1993.01880170071014
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