Introduction

Modern rhinoplasty requires a profound understanding of the complex anatomy of the nose, including the interaction of bony, cartilaginous, and soft tissue structures. The evolution of surgical approaches aims to preserve airway functionality while achieving an aesthetically harmonious outcome.

Objective

To analyze current concepts of the complex nasal anatomy and its influence on rhinoplasty techniques aimed at improving both aesthetics and functionality.

Materials and Methods

The study is based on the analysis of anatomical data, clinical observations, and a comparative evaluation of surgical techniques. Computed tomography, 3D modeling, and statistical data processing were employed for patients who underwent rhinoplasty. The study included 50 participants (30 women and 20 men) who underwent rhinoplasty for aesthetic and functional indications between January 2024 and February 2025.

Patient examinations were performed preoperatively, and subsequently at 1, 3 months, and 1 year postoperatively. The assessment included patient complaints and medical history, laboratory tests according to nosological standards, standard ENT examination, specific functional nasal valve tests (“push-up” test, cotton ball test, Cottle maneuver) and endoscopic evaluation of the nasal cavity. Statistical analysis was performed using IBM SPSS Statistics software.

Results

Analysis of 50 rhinoplasty cases revealed that nasal anatomical features play a key role in determining the surgical technique and predicting outcomes. The main findings include:

1.       Individual Anatomical Variations.

72% of patients demonstrated anatomical characteristics that influenced preoperative planning and surgical techniques. The most significant variations included:

• Variability in the shape and thickness of the osteocartilaginous framework.

• Differences in the angle of nasal septal deviation.

• Various attachment types of the medial crura of the alar cartilages.

• Variations in the structure of the lateral cartilages affecting airway patency.

• Differences in subcutaneous fat layer thickness determining contour modeling complexity.

Key external nasal features in the Kazakh population include:

• Thick nasal tip skin with a pronounced subcutaneous fat layer.

• Low and wide dorsum with a poorly defined cartilaginous hump.

• Broad nasal tip.

• Hypoprojection of the tip.

• Wide alar base.

• Closed V-shaped nostril type.

2.       Influence of Anatomical Features on Surgical Techniques.

In 85% of cases, surgeons emphasized the importance of considering individual anatomy to achieve optimal outcomes. Analysis of surgical procedures identified the following challenging zones:

• Osteocartilaginous junction of the nasal dorsum – high risk of deformities during resection.

• Alar cartilages – critical for maintaining the aesthetic form of the nasal tip.

• Nasal septum – its condition determines the possibility of complete functional correction.

• Soft tissue thickness – patients with thick skin present greater difficulty in achieving a well-defined contour.

Conclusion

Rhinoplasty based on detailed study of nasal anatomy allows minimization of postoperative complications and improvement in the predictability of aesthetic outcomes. Modern technologies, including 3D analysis and computer modeling, contribute to increased precision in surgical interventions.