The superficial musculoaponeurotic system of the nose.

Thirty noses were examined macroscopically and histologically to determine the fibromuscular and aponeurotic layers. There are five soft-tissue components beneath the dermis: a superficial fatty panniculus, a fibromuscular layer, a deep fatty layer, a longitudinal fibrous sheet, and an interdomal ligament. The nose is covered by a nasal SMAS, which forms part of the SMAS of the face. The continuous fibromuscular layer interconnects the musculature through aponeuroses, thus distributing their forces. The alar muscles change the transnasal pressure of the nasal valve, affecting respiration. To preserve the integrity of the nasal soft-tissue layers, one may elevate the soft-tissue envelope beneath the nasal musculature.