The traditional closed rhinoplasty procedure used to produce unstable results, including the "polly beak" deformity, and has largely been replaced by open rhinoplasty, which has now become the new standard. Nevertheless, the complete release of the skin from the nasal skeleton allows for more post-operative swelling, especially if the skeleton is greatly reduced. To enhance nasal definition many surgeons find it necessary to place grafts on the skeleton. This book describes a closed operation that avoids the unstable nose tip of past procedures by preserving the elastic tissue and greatly reduces post-operative swelling. It also presents a novel technique for tip refinement, which elongates the periphery of a dome-shaped tip and a new nose splint. Based on the authors' over 30 years of clinical experience and innovations, this step-by-step guide appeals to experienced surgeons wishing to expand their tools and incorporate the advanced techniques described.
Paul O'Keeffe graduated from the University of Sydney in 1965 and obtained FRCS (England) in 1971. He trained in plastic surgery in Norwich, before returning to Sydney in 1973, where he obtained FRACS (Plastic Surgery). A consultant plastic surgeon at Royal North Shore Hospital, and at Manly District Hospital in Sydney, founder member of the Australasian Society of Aesthetic Plastic Surgery, and distinguished lecturer at international meetings, he has over 30 years of clinical experience, which he is now developing in private practice.