The Radix

Abstract

Why do most surgeons ignore the radix area in their preoperative planning and operations, when the final result can be seriously downgraded by this error of omission? There are probably three reasons. First, they are not aware of how important the radix area and especially the nasion point is for determining all of the major aesthetic angles and proportional relationships in an attractive nose. Second, they do not know how to analyze the radix area and determine its ideal level and height. Third, they are not comfortable augmenting or reducing the radix. This chapter will provide the requisite information to minimize these limitations. The radix area and the nasion are the set point for the na-sofacial and nasofrontal angles, and their consideration is critical when assessing dorsal/base disproportion. The nasofacial angle is based at the nasion and is how everyone assesses the nasal profile. One aspect of the surgical relevance of the radix is appreciated in determining the amount and extent of dorsal reduction. Obviously, if one is going to augment the radix then the amount of dorsal reduction will be less; a very desirable choice in a patient with a psudodorsal hump due to a low radix and underprojecting tip. In contrast, the patient with a full radix often has a nose that begins at the eyebrows and requires maximum radix reduction to create a definite lower starting point for the nose. The surgical techniques presented in this chapter for augmenting and reducing the radix are relatively straightforward and have a low complication rate.