Abstract
The delivery approach, though very appropriate for remodeling the tip of the nose, has been overlooked in recent years and has often been passed over for the open approach. One reason for this is the intercartilaginous incision used for the delivery approach, which may cause scarring at the nasal valve area, leading to postoperative functional obstruction of the nose. The delivery of the alar cartilages is another negative, as this maneuver will disrupt the collagen fibers that attach the upper lateral cartilages to the cephalic margin of the alar cartilages, leading to a weakening of the tip’s support. We propose a modification to the traditional delivery approach by using a transcartilaginous instead of an intercartilaginous incision to prevent damage to the valve area. We also suggest taking advantage of the interference to the tip’s support caused by the disruption of the collagen fibers of the scroll area. The purpose of this article is to describe this modification of the delivery approach and to emphasize the advantages that this controlled interference to the tip’s support may have in selected cases.
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References
Tardy ME (2004) Contemporary rhinoplasty: principles and philosophy. In: Behrbohm H, Tardy ME (eds) Essentials of septorhinoplasty. Thieme, Stuttgart, pp 37–63
Nolst-Trenité GJ (2005) Basic approaches and techniques in nasal tip surgery. In: Nolst-Trenité GJ (ed) Rhinoplasty, 3rd edn. Kugler, The Hague, pp 87–96
Nolst-Trenité GJ, Vinayak BC (2005) External rhinoplasty: the benefits and pitfalls. In: Nolst-Trenité GJ (ed) Rhinoplasty, 3rd edn. Kugler, The Hague, pp 125–141
Nolst-Trenité GJ (2009) Surgery of the nasal tip: intranasal approach. In: Papel ID (ed) Facial plastic and reconstructive surgery. Thieme, Stuttgart, pp 563–576
Xavier R (2009) Tip rhinoplasty—a modified delivery approach. Rhinology 47:132–135
Xavier R (2013) A modified delivery approach. In: Shiffman MA, Di Giuseppe A (eds) Advanced aesthetic rhinoplasty: art, science, and new clinical techniques. Springer, Berlin
Vuyk HD, Zijlker TD (2005) Open-tip rhinoplasty. In: Nolst-Trenité GJ (ed) Rhinoplasty, 3rd edn. Kugler, The Hague, pp 115–123
Adamson PA, Litner JA (2009) Open rhinoplasty. In: Papel ID (ed) Facial plastic and reconstructive surgery. Thieme, Stuttgart, pp 529–546
Whitaker E, Johnson C Jr (2003) The evolution of open structure rhinoplasty. Arch Facial Plast Surg 5:291–300
Farrior E (1999) Dramatic refinement of the nasal tip. Otolaryngol Clin North Am 32:621–636
Tardy ME, Toriumi DM, Hecht DA (2009) Philosophy and principles of rhinoplasty. In: Papel ID (ed) Facial plastic and reconstructive surgery. Thieme, Stuttgart, pp 507–528
Gassner HG, Sherris DA, Friedman O (2009) Rhinology in rhinoplasty. In: Papel ID (ed) Facial plastic and reconstructive surgery. Thieme, Stuttgart, pp 489–506
Han SK, Lee DG, Kim JB, Kim WK (2004) An anatomic study of nasal tip supporting structures. Ann Plast Surg 52:134–139
Han SK, Ko HW, Lee DY, Kim WK (2005) The effect of releasing tip-supporting structures in short-nose correction. Ann Plast Surg 54:375–378
Kim DW, Toriumi DM (2004) Open structure rhinoplasty. In: Behrbohm H, Tardy ME (eds) Essentials of septorhinoplasty. Thieme, Stuttgart, pp 117–135
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Xavier, R. Nasal Tip Plasty: The Delivery Approach Revisited. Aesth Plast Surg 37, 16–21 (2013). https://doi.org/10.1007/s00266-012-0020-1
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DOI: https://doi.org/10.1007/s00266-012-0020-1