Anatomical Analysis and Surgical Correction of Regional Nasal Deformities in Primary Rhinoplasty: A Clinical Observational Study.

Introduction Rhinoplasty is one of the most intricate procedures in facial plastic surgery, requiring a balance between functional restoration and aesthetic refinement. The existing literature often emphasizes comparisons between surgical techniques; however, there is a lack of studies that systematically evaluate deformity distribution across nasal regions and correlate these findings with corrective strategies. This study aims to analyze the anatomical patterns of nasal deformities in primary rhinoplasty patients, and document the region-specific surgical interventions employed. Methods This prospective clinical observational study was conducted at the Department of Otorhinolaryngology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India, from August 2013 to December 2015. Thirty patients (n = 17 males and n = 13 females) with primary external nasal deformities were included. Each patient was evaluated for anatomical involvement - upper two-thirds, lower one-third, or both - and intraoperative corrective techniques, including the use and type of autologous grafts, were recorded. Results Out of the total 30 patients, 14 subjects (46.67%) had deformities involving both the upper two-thirds and lower one-third of the nose, 10 (33.33%) had isolated lower one-third deformities, and six (20.00%) had upper two-thirds involvement only. The most frequent deformity was dorsal hump (n = 24 patients, 80.00%), followed by dorsal deviation (n = 18 patients, 60.00%), reduced columellar support (n = 10 patients, 41.67%), and caudal septal deviation (n = 5 patients, 20.83%). Autologous cartilage grafts were used in 15 patients (50.00%), with septal cartilage used in 13 (86.67%), and conchal cartilage in two subjects (13.33%). Conclusion Region-based anatomical analysis is primary for planning primary rhinoplasty. Customized surgical correction, supported by targeted use of autologous grafts, improves structural integrity and enhances aesthetic outcomes.