To quantify the changes in the strength of nasal tip support associated with various surgical modifications and to identify the procedures that best maintain or augment tip support.

To keep pace with advanccnzents nzadc In faczal plastlc and reconstruct~vc surgery, surgeons continue to search for the deal soft-tlssuefiller A revzezu o f t h e lzterature reveals the advantages, dlsadwntages, nnd rndicatronsfor the use ofln]ectable collagen, Flbrel, autologousfat, andfascla Reccnt sttldles on thc new synfhetrc rnlcctables i~letlzylnzethylpolyslloxalze (Bloplastzque) and polynzethylincthacrylate (Arfecoll) also dlustrate guarded results Expanded polytetrafllioroethylene (GoreTex) has been shozon to be bioconzpatlble and cl~nzcally effcctzve In a varlety ofhead and neck applmtlons In 246 c o n s e c u t m soft-tzssue augrnentntm~s ofnasolab~al creases, wefound Gore-Tex to efface the depth c$ crease srgnlficantly In tzuo patw/?ts, elecflvc reposrtmrng was perfornzcd because of supcrjcral placenzent, Izozuever, there zuere no rnstnnces of extrusion or lnfectron Preoperatzve grading of crease wz~errty reveals that a11 rncreased number of procedures are reqtured to augnzent moderately severe or sczierc nnsolnbrnl folds

Cartilage plating rigid fixation seems to be an effective method of correcting the functional problems associated with severe caudal septal deformities.

No abstract

The need for structural grafting in rhinoplasty arises when the nasal skeletal framework is weakened, malpositioned, or both. This review will be limited to structural grafting of the cartilaginous nasal skeleton. Current techniques will be reviewed and a technique introduced that addresses the common deformity of a superiorly rotated and deprojected nasal tip complex while simultaneously correcting nasal valve collapse. This technique is referred to as the Dynamic Adjustable Rotational Tip (DART) technique. The operative technique of the DART, as well as the basic philosophy regarding the tensile nature of the cartilaginous nasal skeleton will be described.