[Recent developments in esthetic rhinoplasty].

Over the last two decades, the concepts of cosmetic rhinoplasty have advanced, essentially due to the influence of J. Sheen. The importance of the anatomy of osteocartilaginous structures, their dynamic role, and the repercussions of their modification on the external shape has led to a more conservative surgery. Innovations have essentially concerned nose tip surgery and cartilage grafts. The revival of external approach and its popularity constituted the second major development; this can be explained by the direct, visualisation of cartilaginous structures and by the desire or necessity to preserve or reconstruct these structures. The indications for cartilage grafts have become more frequent and graft techniques have been developed and refined. The difficulties encountered in the use of autologous grafts have favoured the development of many new implants. Parietal cranial grafts occupy an increasingly important place in the indications for nasal bone grafts.