![](../../../imagens/12-01-04-fig01.jpg)
Fig. 1 - Trans-operative view oftransverse media-collumelar incision. It must be broken by an inverted "V" in order to prevent future retractions in this area.
![](../../../imagens/12-01-04-fig02ab.jpg)
Fig. 2a) - Schematic representation af the transverse medio-collumelar incision. b) - The marginal incisions should be placed alongside the caudal edge ofthe lateral crura, domus and medial crura where they meet with the media-collumelar incision at right angles.
![](../../../imagens/12-01-04-fig05.jpg)
Fig. 5 - Comparing clased and open techniques, the difference in undermined areas is minimal (approx. 0,5 cm
2).
![](../../../imagens/12-01-04-fig06a.jpg)
Fig. 6a - Preoperativefront view ofa patient with important rhinoseptal deviationfrom trauma.
![](../../../imagens/12-01-04-fig06b.jpg)
Fig. 6b - Post-cperative front view after correction by extental approach and complete rhinoseptoplasty.
![](../../../imagens/12-01-04-fig06c.jpg)
Fig. 6c - Preoperative perfil view of the same case.
![](../../../imagens/12-01-04-fig06d.jpg)
Fig. 6d - Postoperative view after correction.
![](../../../imagens/12-01-04-fig07a.jpg)
Fig. 7a - Preoperative front view ofa patient with sequelae ofprevious rhinoplasty. Notice misalignement of nasal pyramide and asymetric bulbous tip.
![](../../../imagens/12-01-04-fig07b.jpg)
Fig. 7b - Post-operative view after correction through an open approach.
![](../../../imagens/12-01-04-fig07c.jpg)
Fig. 7c - Basal view. Important asymetria is noticed.
![](../../../imagens/12-01-04-fig07d.jpg)
Fig. 7d - Basal post-operative view ofthe result achieved. lnconspicous scar in the collumela.
![](../../../imagens/12-01-04-fig07e.jpg)
Fig. 7e - Perfil preoperative view of the same case.
![](../../../imagens/12-01-04-fig07f.jpg)
Fig. 7f- Post-operative view.
![](../../../imagens/12-01-04-fig08a.jpg)
Fig. 8a - Preoperative aspect of a patient with discret dorsal hump. broad tip and septal deviation in zone 2.
![](../../../imagens/12-01-04-fig08b.jpg)
Fig. 8b - Post-operative aspect after rhinoseptoplasty by external approach.
![](../../../imagens/12-01-04-fig08c.jpg)
Fig. 8c - Perfil preoperative view of the same patient.
![](../../../imagens/12-01-04-fig08d.jpg)
Fig. 8d - Post-operative view.