Terms and Definitions will help you understand your future rhinoplasty procedure
Accessory Cartilages: are the small cartilages that support the internal and external nasal valves lateral to the lateral crus of the lower lateral cartilages.
Ala: is the soft tissue structure lateral to the tip covering the nostrils made of fibro-fatty tissue and devoid of significant cartilages.
Alar Base: is the base of the nose formed by the portion of the Ala connected to the face.
Alar Crease: This is the groove or crease above the Ala. It is associated approximately to where the Interal Nasal Valves are found. Below you will find a picture that can help you understand the terms below and where the Alae are located:
Anterior Septal Angle: is the portion of the septum that is at the anterior most connection between the caudal and dorsal struts of the septum. It is the area closest to the tip and is important for the location and aesthetics of the tip.
Binder Syndrome: is a developmental disorder or a natural variance in anatomy that affects the anterior part of the maxilla and nasal anatomy. It is characterized by a lack of development of the nasal septum, and premaxilla. It can include an absence of the nasal spine. People who have this can have the appearance of a flat midface, short nose, and flat nasal bridge.
Bony Nasal Vault: This is the entrance to the nasal cavity delineated by the premaxilla, nasal processes of the maxilla, the frontal processes of the maxilla, and the paired nasal bones. Osteotomies through the bony vault allow the root to be narrowed. Osteotomies through the nasal bones allow the bridge to be narrowed.
Caudal Nose: Is the nose closest to the feet as opposed to the portion of the nose closest to the top of the head termed cephalic.
Cephalic Nose: is the direction related to elements closest to the head in contrast to the Caudal Nose.
Columella: this is the column of tissue that is located between the nostrils. Incisions through this structure formed the basis of the open approach.
Columellar Strut: This is a piece of cartilage that is used to make the lower lateral cartilages and specifically the medial crura to be stronger. This allows the tip complex to withstand healing forces to keep the tip projected.
Columellar-Lobule Angle: is the angle formed by the association and connection between the lobule and the columella. It is found to be normally between 15-45 degrees.
Conchal Ear Cartilage Graft: This is a graft that is taken from the ears at the bowl region where the appearance of the ear will not be affected. The incision is approached from behind the ear and so the scar is well hidden.
Dome: This is the area of the tip that contributes to the light reflex that defines the tip width. It is located at the junction of the lateral and intermediate | middle crus.
Dorsum: Is the bridge of the nose. It is comprised of the middle third of the nose and the association of the septum with the upper lateral cartilages. It is also made of bone at the upper third of the nose. The portion contributing to the dorsum or bridge of the nose is different based on each individual. Some have more cartilage making up the bridge | dorsum. Some have more bone making up the bridge of the nose.
External Nasal Valve: This is the area delineated by the nostrils and inside portion of the columella. 10-15 % of your airway resistance to breathing of the entire airway (lungs included) is located here. The Internal nasal valve is just superior to this location.
Footplate: This the continuation of the media crura that approaches from the columella into the nasal sill. It creates the smooth continuation from the columella to the sill area. This area can also impact the airway if this area is particularly wide or large.
Frontal View: This is the view of the nose from the front the way someone looks at you when talking to someone face to face.
Funtional Rhinoplasty: This is the approach to Rhinoplasty that concentrates on the functioning of the nose. Straightening the septum and improving the functioning of the Internal and External Nasal Valves takes precedence in Functional Rhinoplasty.
Hanging Ala: The nostril is assessed on the side of the nose by a line drawn through the most anterior and posterior parts of the nostril. From there, the nostril should be 1-2mm above and below this line. A Hanging Ala obscures this ideal in part, or completely obscuring the nostril from the side view.
Infratip Lobule: is the segment of tissue inferior to the tip defining points and superior to the apex of the nostrils.
Intercartilagionous: this is the space or location between the Upper Lateral Cartilages and the Lower Lateral Cartilages. The area is often called the scroll area. It is a common place for incisions to facilitate the closed approach.
Internal Nasal Valve: This is the area that coincides with the inferior most edge of the upper lateral cartilages, the angle of association of the Upper Laterals and the Septum, and the floor of the nose. 50% of the airway resistance of the whole airway from nostrils to lungs and their bronchioles are found here. So for breathing the Internal Nasal Valve is incredibly important. From the outside it is located in the crease above the tissue that covers your nostrils (Ala), or Alar Crease.
Keystone Area: This is junction between the nasal bones and the Upper Lateral Cartilages and Septum. It is between the upper and middle third of the nose. Its association is important for the relation between the bony segments and cartilage segments. This includes the association of the bone with the cartilages the adherence of the bone to the cartilage and the importance this adherence and association means to the whole nasal structure and its stability.
Limen Vestibuli: Is the location where the nostril skin and hair typography ends transiions to the mucosa of the nasal cavity. It is also the location where the Internal Nasal Valve is located.
Lower Lateral Cartilages: These are the cartilages that are in the lower third of the nose that control the size of the nostrils and the shape of the nasal tip. Hence, manipulating them is crucial to the shape of these areas and it is generally thought to be the hardest area to work on.
Marginal Incision: This is the incision that is directed at the inferior margin of the lower lateral cartilages. It is part of the open approach and closed approach distinguished by the transcolumellar incision that is present in the open approach but absent in the closed approach.
Medial Crura: This is one of the 3 parts of the lower lateral cartilages. It is part of the structure within the columella. The footplates are the portion that extends on to the floor of the nostrils and the fooxtplates helps to create the structure here.
Nasal Lobule: This is another word for the tip area. It is part of the lower third of the nose. It is bounded posteriorly by the anterior edge of the nostrils, posteriorly by the inferior end of the dorsum, and laterally by the anterior part of the ala.
Nasal Pyramid: This is the bony perimeter made up of the paired maxillary bones and the nasal bones.
Nasion: This the depression at the junction of the nose and the forehead's glabella segment. It is the soft tissue representation of the bony landmark radix.
Nasolabial Angle: This is refers to the technical term for the tip rotation and positioning. On the side view, your nostrils will have an anterior and posterior end. A line drawn through these points is the general position of the tip and nose at this location. Then how it relates to a vertical plane will determine the Nasolabial Angle. The ideal is 93-99 degrees for males, and 96-100 for females.
Nostril Sill: This is the segment of tissue from columella to the alar base.
Pyriform aperture: This is similar to the Nasal Pyramid but refers to the opening of the nasal cavity.
Radix: This is the bony location of the junction of Glabella and Nasal Bone. It is usually the inferior most location of the nose or the closest that the nose gets the to face.
Rhinion: This is the junction of the nasal bones and the septum and upper lateral cartilages. Usually it refers to the center of this junction.
Scroll Area: This is the scroll like connection between the upper lateral cartilages and lower lateral cartilages much like to hands holding each with their fingers curled. The function of this connection helps to support the airway.
Sesamoid Cartilages: small cartilages that are lateral to the upper and lower lateral cartilages that are connected by connective tissue. They play a role in hold support for this area and helping the resilience in this airway that supports the airway.
Soft Triangle: This is located lateral and inferior to the tip and dome areas. It is located at the inferior lateral point of connection between the lateral and intermediate or middle crus.
Subnasale: This is the junction of the columella with the upper lip. It indicates the end of the nose.
Supratip area: This is the area above the tip. It marks the beginning of the nasal dorsum | bridge and the bottom of the middle third.
Tip: The most projecting part of the lower third. It is the location of the point that attracts the most attention within the nose.
Tip defining points: These are the points that create a highlight in the tip. It defines the general size of the tip.
Tip projection: This is the distance that the tip projects from the face or specifically the alar base or the most posterior part of the nose cheek junction.
Tip Rotation: This is mathematically defined by the nasolabial angle. Rotation increases as the tip shifts upward while the nose base and the most inferior point of the nose stays the same. Derotation occurs when the tip position moves inferiorly as the nose base and most inferior point of the nose stays the same.
Transfixion incision: this is an incision that is placed inside the nostril along the inside of the columella that is between the medial crura and the caudal septum. A hemitransfixion incision goes through only one side or not all the way through from superior to inferior in this space.
Upper lateral cartilages: These are the cartilages that are superior to the lower lateral cartilages that make up the middle third. They attach to the midline septum and to the nasal pyrimad directly and through fibrous connections respectively.