Functional Outcomes of Structured Nasal Tip Refinement

Abstract

A technique is described allowing refinement of the nasal tip while maintaining or improving the nasal airway and providing a high level of patient satisfaction with the aesthetic outcome. Even in patients seen for cosmetic rhinoplasty, there may be a degree of preoperative nasal obstruction that should be recognized and addressed.

Functional and Cosmetic Outcomes of External Approach Septoplasty

“…However, the incision is cosmetically acceptable. 35 Tip and dorsal edema are greater than extracorporeal approaches, but without tip-modifying surgery techniques are short lived.…”

Lateral Crural Tensioning for Refinement of the Wide and Underprojected Nasal Tip

“…The eventual result is often severe distortion of the nasal tip leading to lobular pinching, alar retraction, bossae formation, asymmetry, excessive tip rotation, unwanted loss of tip projection, and/or symptomatic nasal valve collapse. [1][2][3][4][5][6][7][8][9][10][11][12]20,24,25 Patients with naturally weak tip cartilage are at disproportionally high risk for morbidity after the cephalic trim maneuver because the tip is already at or near the threshold for collapse, and these patients often develop unsightly tip deformities despite comparatively modest cephalic resections. [1][2][3]24 Moreover, tip width does not correlate with cartilage stiffness, and overly pliable, weak tip cartilages are often encountered in ultrawide bulbous noses.…”

“…Structural techniques that enhance skeletal support for improved contour stability and nondestructive suture-based techniques that reshape and reposition malformed or malpositioned tip cartilages have transformed the quality and long-term predictability of tip rhinoplasty. [1][2][3][4][5][6][7][8][9][10][12][13][14][15][16][17][18] Over this same time period, however, comparatively little attention has been directed at another important anatomic deformity common to the CTD: the crural length disparity that results from malposition of the nasal domes. Despite the adverse impact on tip aesthetics, maldistribution of tip cartilage is a critical aberration of tip architecture that can dramatically affect lobular contour, supratip contour, tip support, sidewall aesthetics, and nasal valve function, yet one that is often overlooked, undertreated, and/or mismanaged.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Although this trend is rapidly spreading among rhinoplasty enthusiasts, the number of failed rhinoplasty outcomes stemming from cartilage overresection seems to be growing rapidly, suggesting that aggressive excisional techniques are still practiced widely even today. 1 Nonetheless, there are now safe and effective alternatives to excisional rhinoplasty in which little if any tip cartilage excision is required.…”

Rhinoplasty Complications and Reoperations: Systematic Review

“…We ran the information from the Excel table through a statistical analysis 14 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 …”