Template Rhinoplasty Operation

1. Mark forehead key
2. Mark bridge reduction with template on side of nose
3. Inject local anaesthetic and adrenaline as usual
4. Incise septal mucosa at junction of mobile and fixed mucosa and cross cut for reference
5. Expose septal caudal margin and reduce as planned
6. Intra- or inter-cartilaginous vestibular incision extends laterally to pyriform margin
7. Resect measured amount of lateral alar ligament and mucosa
8. Carefully elevate skin and underlying muscle off the upper lateral cartilages
9. Skeletonise pyramid widely and reduce dorsum until matches new bridge line
10. Medial nasal osteotomy
11. Lateral nasal osteotomy via lateral alar ligament window
12. In-fracture and bone graft to dorsum and lateral osteotomy if gap
13. Suture septal mucosa according to planned setback, suture lateral alar ligaments and suture vestibular incisions
14. Tape, splint and pack nose
15. Eye pads to reduce peri orbital ecchymosis

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