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Rhinoplasty in Practice: Illustrated Guide to the Book
Quick answer: Rhinoplasty in Practice: An Algorithmic Approach to Modern Surgical Techniques is a surgeon's textbook by Prof. Dr. Süleyman Taş, first published in 2021 by CRC Press (Taylor & Francis). It teaches closed, atraumatic rhinoplasty in seven chapters, from patient selection to advanced rhinoplasty, with step-by-step algorithms and companion videos. This illustrated guide explains its core ideas in plain language, using figures from the book.
Key takeaways
The book is built around closed atraumatic rhinoplasty: the nose is reshaped through small incisions while the surrounding tissues are preserved and supported.
Incisions made inside the cartilage resist scar contracture better, so the book prefers intracartilaginous incisions whenever possible.
Submembranous (subperichondrial and subperiosteal) dissection is described as the most bloodless surgical plane; for thick-skinned noses the author uses a combined DUAL plane.
The tripod concept explains how each tip technique changes tip rotation, projection and the lengths of the lateral and medial crura.
Seven chapters cover patient selection, closed technique, dorsum, nasal tip, alar base, revision and advanced rhinoplasty (male, female, thin and thick skin, Asian, African and Middle Eastern noses).
What is Rhinoplasty in Practice?
Rhinoplasty in Practice is the first English-language textbook by Prof. Dr. Süleyman Taş, a plastic surgeon in Istanbul who also trained in microsurgery. The book was published in 2021 by CRC Press, an imprint of Taylor & Francis (ISBN 978-1-032-00434-1 hardback, 978-1-032-00435-8 paperback, 978-1-003-17416-5 e-book; DOI 10.1201/9781003174165). Its subtitle, "An Algorithmic Approach to Modern Surgical Techniques", describes the method: instead of one fixed operation, the surgeon follows decision algorithms that match the technique to the nose in front of them.
On this website the book has its own page with the table of contents, purchase links, reviews and 50 companion videos: Rhinoplasty in Practice, the book and its videos.
The core idea: closed atraumatic rhinoplasty
The philosophy of the book starts from the medical principle "Primum non nocere" (first, do no harm). In the author's words:
"Atraumatic approach in rhinoplasty = not only preserve but also support." Prof. Dr. Süleyman Taş, Rhinoplasty in Practice, Chapter 2.
The book teaches this through the closed technique because it requires fewer cuts. It describes the nose as a house with many rooms (the Room Concept): the open technique has to cut through many walls to reach each room, whereas the closed technique is limited to the selected regions where work is needed.
The four fundamental closed atraumatic incisions are the inferior intracartilaginous, the superior intracartilaginous, the hemitransfixion and the lateral osteotomy incisions. The classic rhinoplasty incisions (trans-cartilaginous, inter-cartilaginous, marginal and trans-columellar) are described for comparison. Incisions placed in the cartilage better withstand scar contracture forces during healing, which lowers the possibility of distortion and asymmetry.
The anatomy the book builds on
Every technique in the book rests on the anatomy of the bony and cartilaginous framework and the soft tissue envelope around it. Bone and cartilage have the lowest metabolism of the nasal structures and receive nutrients by diffusion from their membranes, while the blood supply of the nose is concentrated in the SMAS layer (the superficial muscular and fibrous layer under the skin).
Dissection planes: submembranous, subSMAS and the DUAL plane
Chapter 2 compares the two main planes of dissection. In the submembranous plane the surgeon works under the perichondrium of the cartilage and under the periosteum of the bone; the book describes it as the most bloodless plane that can be achieved. The author designed two instruments, TAŞ1 and TAŞ2, to enter this plane without damaging the cartilage. In the subSMAS plane the dissection is above the perichondrium, which is the generally accepted routine plane.
Because the submembranous plane leaves a thick soft tissue cover, the book prefers the DUAL plane for thick-skinned patients: a combined dissection that is subperichondrial over the lower lateral cartilages, subSMAS in the supratip area where the envelope is thick, and subperichondrial again in the keystone area where the envelope is thin. This lets the surgeon redistribute the soft tissue envelope more evenly when it is redraped.
The book also maps the "walls" a surgeon meets between the rooms of the nose: the scroll ligament between tip and dorsum, the pyriform (pyramidal) ligament between the cartilaginous and bony dorsum, and the Pitanguy ligament in the central border between tip and dorsum. The author named the region where the perichondrium splits at the keystone the transition zone, based on his published clinical and cadaver studies.
The nasal tip: the tripod concept and the supratip break point
Chapter 4 explains the cartilage of the nasal tip as a tripod. Because the lateral and medial crura of the lower lateral cartilage form a hemi-circular geometry, shortening one leg changes the other. A lateral steal increases tip rotation, while a medial steal decreases it; lateral overlapping shortens the lateral crus and increases rotation but decreases projection. A table in the book summarizes how each technique changes rotation, projection and crural length, so the surgeon can choose the maneuver that matches the planned change.
The supratip break point is the subtle transition between the tip-defining point and the dorsum. The book states that the tip-defining point should sit 2–3 mm higher than the septal angle in thin-skinned patients and 5–6 mm higher in thick-skinned patients. Too little definition can look like a false saddle nose, while excess fullness can cause a supratip or "parrot nose" deformity.
The book also asks the surgeon to study the nostril from the front and the side. It classifies four profile deformities along the long axis of the nostril: hanging columella, hanging ala, retracted columella and retracted ala.
The dorsum: from excision to preservation
Chapter 3 treats the dorsum in three parts: the excisional approach, the dorsum preservation approach and a dorsum algorithm for reduction rhinoplasty. The book traces dorsum preservation back to J. L. Goodale in 1899, who described the first "down" technique, and to M. H. Cottle's 1954 paper on nasal roof repair, which presented the "push down" concept. Preservation techniques covered include push down, let down, the Skoog technique, the retractable roof technique, fix down and the dorsal roof technique, with step-by-step descriptions. The excision side covers techniques such as component hump removal and the bone dust technique, and the chapter ends with dorsum augmentation, including the ultradiced cartilage method.
Chapter-by-chapter guide
Chapter 1, Patient Selection: patient identification, physical, psychological, functional and aesthetic evaluation, simulation study and revisit.
Chapter 2, Closed Atraumatic Rhinoplasty: local injection, incisions, dissection plane, preservation, reshaping, reconstruction, structure, redraping and closure; open versus closed comparison.
Chapter 3, Dorsum Surgery: osteotomy, osteoplasty, maxilloplasty, dorsum excision, dorsum preservation and dorsum augmentation.
Chapter 4, Nasal Tip Surgery: tripod concept, lower lateral cartilage flaps, ST flap, columellar strut and septal extension grafts, the Pitanguy ligament, deep SMAS suture, soft tissue redraping, electrocautery and the blinking nose deformity.
Chapter 5, Alar Base Surgery: alar excision, alar base narrowing suture, alar base symmetry, releasing the piriform ligament, maxillary hypoplasia and the depressor septi nasi muscle.
Chapter 6, Revision Rhinoplasty: dissection planes in revision, the closed approach for challenging cases, saddle nose deformity, rib and auricular cartilage, diced cartilage flap, tip mobility, over-rotated noses and the fisherman suture.
Chapter 7, Advanced Rhinoplasty: the male nose, the female nose, thin and thick skin, the DUAL plane, and Asian, African and Middle Eastern rhinoplasty.
Glossary of key terms from the book
Atraumatic approach: preserving and supporting the nasal tissues instead of removing or destroying them.
Room Concept: the nose seen as a house of separate rooms divided by ligamentous and soft tissue walls.
Submembranous dissection: dissection under the perichondrium and periosteum, the most bloodless plane.
DUAL plane: combined subperichondrial and subSMAS dissection chosen by skin thickness region by region.
Transition zone: the keystone region where the perichondrium of the upper lateral cartilage divides and joins the periosteum of the nasal bone.
Tripod concept: the model of the tip cartilages used to predict how a maneuver changes rotation and projection.
Supratip break point: the tip-defining point slightly above the septal angle that gives the nose an elegant profile.
Pitanguy ligament: a fibrous structure between tip and dorsum first described by Ivo Pitanguy in 1965; the book shows it is SMAS tissue and that it can stay intact in the closed technique.
TAŞ1 and TAŞ2: instruments designed by the author for atraumatic entry into the subperichondrial and subperiosteal planes.
Watch the techniques
The book is paired with video demonstrations. Each of the 50 videos on this site has its own page with a written description, for example Pitanguy ligament in the open technique. The full indexed list is on the Rhinoplasty in Practice page.
Frequently asked questions
What is Rhinoplasty in Practice about?
It is a surgical textbook on rhinoplasty that teaches a closed, atraumatic and algorithm-based approach across seven chapters, from patient selection to advanced and ethnic rhinoplasty.
Who wrote Rhinoplasty in Practice and who published it?
Prof. Dr. Süleyman Taş wrote it. The first edition was published in 2021 by CRC Press, an imprint of Taylor & Francis Group.
What is closed atraumatic rhinoplasty?
It is a rhinoplasty philosophy in which the surgeon works through a few small incisions, keeps the membranes that nourish bone and cartilage, and aims not only to preserve but also to support the nasal structures.
What is the DUAL plane?
The DUAL plane is a combined dissection described by the author for thick-skinned noses: subperichondrial over the lower lateral cartilages, subSMAS in the thick supratip area and subperichondrial in the thin keystone area.
Does the book have videos?
Yes. The book has companion videos, and this website hosts 50 of them with individual description pages, listed on the book page.
Is the book written for patients?
No. It is written for surgeons and surgical trainees. Patients who want a plain-language guide can read the author's book for patients, "Win by a Nose", or book a consultation.
This article summarizes a surgical textbook for educational purposes and is not medical advice. To discuss your own nose, book a consultation with Prof. Dr. Süleyman Taş.
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