I have been assigned a number of lectures today, and I hope that I am able to provide you with some practical information that you will find useful in your own practice. In this lecture, I am going to speak about the complex and the severely twisted nose.

You can think of the nose, of course, as having an upper, middle and lower thirds, and the nose can be severely deviated in all three portions, and we will talk about those. We will also talk about the cleft lip nasal deformity. The cleft lip nasal deformity is a complicated deviation with multiple component parts. This nasal deformity provides a useful teaching opportunity because, even though it is complex, it is anatomically a predictable deviation. The cleft lip nasal deformity is a good starting point for consideration of complex nasal deviations. We will also discuss other complex deviations, and as with all rhinoplasty they require careful anatomic preoperative nasal analysis. Of course, in all cases, precise anatomic diagnosis is the critical first step for successful treatment. Breaking down the anatomic reasons for the deviation into their component parts allows methodical treatment.