Osteotomy is one of the major parts of rhinoplasty. External lateral osteotomy, which is performed through a small puncture incision of the skin, has numerous advantages, although visible scar seems to be its unfavorable side effect. To evaluate the incidence of scar formation after external lateral osteotomy, we observed 98 consecutive cases that had undergone the external lateral osteotomy. Rhinoplasty was performed by a single surgeon from February 23 to March 28. The patients were examined for scar visibility 2 weeks and 2 months after the surgery by two other plastic surgeons. We found visible scars at the percutaneous puncture sites in 3% of the patients at 2 weeks after surgery and in 2% after 2 months. They were two men with dark and thick skin. Percutaneous lateral external osteotomy is an easy and precise approach with an excellent result at the puncture sites. It needs good technique and patient selection. We suggest this technique for female patients with thin skin.
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