Killian incision

An incision used for septoplasty and septal cartilage harvest. It is placed just beyond where the septum starts and is less destabilizing than a hemitransfixion or full transfixion incision.

A Killian incision is an internal incision used to reach the nasal septum during septoplasty or cartilage harvesting. It is placed farther back from the front edge of the septum than a hemitransfixion or full transfixion incision. Because it does not begin directly at the caudal edge, it can provide access to selected septal problems while disturbing less of the support near the nasal tip.

This incision is often useful when the main deviation, spur, or bony obstruction is located in the middle or back portion of the septum. It allows the surgeon to lift the mucosal lining and correct the targeted area without elevating a longer flap from the very front of the nose. In endoscopic septoplasty, a limited Killian incision may be placed near the specific deformity to reduce unnecessary dissection.

The tradeoff is that a Killian incision provides less direct access to the caudal septum. If the deviation involves the front edge of the septum, the columella, or structures that support the tip, another incision may offer better exposure. Incision choice is therefore based on the location and shape of the problem, not on a single preferred approach for every patient.

For patients considering septoplasty or rhinoplasty in Beverly Hills, understanding the Killian incision can help explain how internal septal work is planned. Dr. Richard Zoumalan evaluates where the deviation is located and how much access is needed before choosing an incision that supports precise correction while preserving nasal stability.