The keystone: Consistency in restoring the aesthetic dorsum in rhinoplasty

The keystone represents the union of six distinct anatomical structures between the bony vault and the cartilaginous midvault. In reshaping the nasal dorsum, the individual components of the nose respond variably as the fusion points of the keystone are released. In restoring the nasal dorsum, meticulous effort is made to equalize the width between the bony vault and the cartilaginous midvault. Techniques used for width equalization will yield gratifying long-term results and avoid common pitfalls such as the inverted-V deformity.