RETAINING A CORRECT SEPTOLABIAL ANGLE IN RHINOPLASTY

For many years rhinoplastic surgeons have been confronted with the problem of preventing a widening or a weblike distortion of the septolabial angle following the classic procedure for shortening the nose, i. e. (1) transsection of the membranous septum down to the anterior nasal spine of the maxilla, (2) reduction of the septum and upper lateral cartilages and (3) reattachment of the columella to the septum. In carrying out step 3 overcorrection is essential to compensate for the subsequent inevitable contraction due to cicatrization of the transfixed membranous septum. With this in mind, Jacques Joseph, of Berlin, in 1898 devised the septocolumellar suture to raise the tip of the nose, 1 and this method became the standard practice in rhinoplasty and is meticulously followed at the present time. A heavy silk suture is passed through the septal cartilage and the columella in an oblique fashion, so that when the suture is