Surface Aesthetics in Tip Rhinoplasty: A Step-by-Step Guide

Abstract

Tip rhinoplasty is a key component of aesthetic rhinoplasty. An understanding of the correlation between tip surface aesthetics and the underlying anatomic structures enables proper identification and correction of tip abnormalities. Surface aesthetics of the attractive nose are created by certain lines, shadows, and highlights with specific proportions and breakpoints. In this Featured Operative Technique, the authors describe a stepwise process for tip rhinoplasty that conceptualizes aesthetic subunits as geometric polygons to define the existing deformity, the operative plan, and the aesthetic goals. Tip rhinoplasty is described in detail, from initial markings through incisions and dissection. The autorim graft concept is explained, and lateral crural steal and footplate setback techniques are described for the attainment of symmetric domes with correct lateral crural resting angles. Methods in columellar reconstruction are described, including creating the columella (C') breakpoint and the infralobular caudal contour graft. The principal author (B.Ç.) has applied these techniques to 257 consecutive "polygon rhinoplasties" over the past 3 years.

Utilization of Rhinoplasty Worksheets among Practicing Facial Plastic Surgeons

“…Additionally, with rhinoplasty now more than ever going through a period of rapid evolution with techniques such a preservation rhinoplasty regaining popularity, 12 , 13 and refinements to both endonasal and open rhinoplasty continuing to emerge, a universal format to describe rhinoplasty surgery seems necessary. 5 , 14 , 15 …”

Nasal reconstruction surgery after continuous positive airway pressure delivered by prongs: A case report

“…Symmetry of the left–right ala nasi and the patient's nasal tip was achieved by releasing the contracture scar; as this procedure resulted in excess skin, a cut-as-you-go excision was performed to ensure that the nasal tip appeared symmetrical. The excision line was positioned according to the location of the soft-triangle facet, with the intention that any resultant scarring would fall within the facet cavity and thus be imperceptible [ 17 , 18 ].…”

“…Evaluations made 5 days and 1-month after the surgery met the following benchmarks: right and left ala nasi symmetry; nasal protrusion with a diamond shaped tip; and a columella forming a nasolabial angle of approximately 120° ( Fig. 2 C) [ [17] , [18] , [19] ].…”

Versatility of the Fixed-Mobile Septal Extension Graft for Nasal Tip Reshaping

“…Medial crural division and overlap allows for precise adjustment of tip projection. 4,9,10 Another advantage of these cartilage-division techniques is the correction of potential length discrepancies between the two lower lateral cartilages, which are corrected with asymmetric degrees of overlap between the two medial crura. 10…”