Transfixion incision

An incision in the septum in front of where it starts inside the nose. This incision is used to access the septum for septoplasty and for harvesting septum to be used in rhinoplasty or vestibular stenosis repair.

A transfixion incision is an internal incision made along the front edge of the nasal septum. It provides access to the septal cartilage and surrounding tissues without creating a visible scar on the outside of the nose. Depending on the procedure, the incision may extend across both sides of the membranous septum or be limited to one side as a hemitransfixion incision.

This approach may be used during septoplasty, cartilage harvesting, tip-delivery rhinoplasty, or repair of structural narrowing inside the nose. It allows the surgeon to lift the tissue covering the septum and work on cartilage or bone that is bent, damaged, or needed for grafting. Because septal cartilage often provides useful material for rhinoplasty, this incision can serve both functional and reconstructive parts of the operation.

The transfixion incision is close to structures that help support the nasal tip, so its extent and placement matter. A full transfixion incision can reduce some tip support and may contribute to deprojection, while a limited incision may preserve more of the existing framework. The surgeon must also protect the mucosal lining and leave an adequate L-strut of septal cartilage to maintain long-term stability.

For patients considering septoplasty or rhinoplasty in Beverly Hills, understanding the transfixion incision can help explain how the septum is accessed internally. Dr. Richard Zoumalan chooses the incision based on the location of the problem, the amount of exposure needed, and the importance of preserving tip and septal support.