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A. The nasal soft tissues Nasal skin – Like the underlying bone-and-cartilage (osseo-cartilaginous) support framework of the nose, the external skin is divided into vertical thirds (anatomic sections); from the glabella (the space between the eyebrows), to the bridge, to the tip, for corrective plastic surgery, the nasal skin is anatomically considered, as the: Upper third section – the skin of the upper nose is thick, and relatively distensible (flexible and mobile), but then tapers, adhering tightly to the osseo-cartilaginous framework, and becomes the thinner skin of the dorsal section, the bridge of the nose. Middle third section – the skin overlying the bridge of the nose (mid-dorsal section) is the thinnest, least distensible, nasal skin, because it most adheres to the support framework. Lower third section – the skin of the lower nose is as thick as the skin of the upper nose, because it has more sebaceous glands, especially at the nasal tip. Nasal lining – At the vestibule, the human nose is lined with a mucous membrane of squamous epithelium, which tissue then transitions to become columnar respiratory epithelium, a pseudo-stratified, ciliated (lash-like) tissue with abundant seromucinous glands, which maintains the nasal moisture and protects the respiratory tract from bacteriologic infection and foreign objects. Nasal muscles – The movements of the human nose are controlled by groups of facial and neck muscles that are set deep to the skin; they are in four (4) functional groups that are interconnected by the nasal superficial aponeurosis—the superficial musculoaponeurotic system (SMAS)—which is a sheet of dense, fibrous, collagenous connective tissue that covers, invests, and forms the terminations of the muscles. The movements of the nose are affected by the elevator muscle group – which includes the procerus muscle and the levator labii superioris alaeque nasi muscle. the depressor muscle group – which includes the alar nasalis muscle and the depressor septi nasi muscle. the compressor muscle group – which includes the transverse nasalis muscle. the dilator muscle group – which includes the dilator naris muscle that expands the nostrils; it is in two parts: (i) the dilator nasi anterior muscle, and (ii) the dilator nasi posterior muscle.

Rhinoplasty: the surgical nose as aesthetic nasal segments. B. Aesthetics of the nose – nasal subunits and nasal segments To plan, map, and execute the surgical correction of a nasal defect or deformity, the structure of the external nose is divided into nine (9) aesthetic nasal subunits, and six (6) aesthetic nasal segments, which provide the plastic surgeon with the measures for determining the size, extent, and topographic locale of the nasal defect or deformity.

The surgical nose as nine (9) aesthetic nasal subunits tip subunit columellar subunit right alar base subunit right alar wall subunit left alar wall subunit