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A Structural Model to Systematically Understand Nasal Framework: The Rhinoplasty Compass

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This chapter discusses using a prism-shaped model how the key structure in external nasal anatomy and the nasal airway is the nasal framework. The nasal framework consists of the anterior and inferior septum and the nasal bones superiorly. Superficially located to the framework is the canopy layer consisting of the paired alar cartilages and the skin and soft-tissue layer. Supporting the framework is the foundation layer, or substrate, consisting of the septal bones and pyriform aperture. Using the prism model, this key chapter analyzes the variations of framework external extrusion, from supero-inferior excess and deficiency (SI+/−) to antero-posterior excess and deficiency (AP+/−), and how combinations of these variations can be visualized on a compass-like structure, we call the Rhinoplasty Compass. By categorizing patients on this compass, predictable esthetic, deviation, and functional phenotypes can be better understood.


  • Rhinoplasty triangular prism model
  • Nasal foundation
  • Nasal framework
  • Nasal canopy
  • Septal excess
  • Septal deficiency
  • Rhinoplasty compass

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  • DOI: 10.1007/978-3-030-44674-1_5
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  1. 1.

    As we will discuss later, the release of the lateral crura of the alar cartilages from its attachment to the framework at the septum and upper lateral fusion via the inter-cartilaginous incision itself can release the inferior directed tip cartilages in a cephalic direction, but this does not require any trim, thus observers of the rotation mistakenly ascribed the removal of alar cartilages to being the source of rotation.


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Stupak, H.D. (2020). A Structural Model to Systematically Understand Nasal Framework: The Rhinoplasty Compass. In: Rethinking Rhinoplasty and Facial Surgery. Springer, Cham.

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