Gradual approach to refinement of the nasal tip: surgical results

Abstract

The protocol used allowed the implementation of a gradual surgical approach to nasal tip definition with the nasal anatomical characteristics, high rate of patient satisfaction with the surgical outcome, and low rate of revision.

Shaping the nasal tip: A new approach to transdomal suturing

“…[3] The minimum diagnostic criteria for PPS are any three of the following: cleft lip/palate, popliteal pterygium, paramedian lower-lip pits/sinuses and genital and toenail abnormalities. [4] Lower-lip pits, which may resemble a depression or furrow, represent the opening of a tract leading from a mucous gland embedded in the lip. [3] Lip pits may be divided into three types according to their location: commissural, midline upper lip and lower lip.…”

“…The advantages of the proposed new approach to transdomal suturing become clearer, if one takes into account the problems in shaping the nasal tip, which may be encountered in every day practice. [4] These problems become especially obvious in case a surgeon decides to change the tip definition, in combination with an overlay technique and cartilage division at the tip area, when lower lateral crus struts are used, and in revision cases, where the domal area is damaged and the domal cartilage too thin. Placing the stitch down to the collumelar segment of the medial crus, in the aforementioned cases, is more easily performed compared to the traditional mattress TDS technique, as this area is relatively untouched, and the surgeon may avoid crowding the domal area with knots, which may also add to its friability.…”