At the center of the tip, the tip points (TPs) are the single most defining feature of a nose. In a random survey (N= 146; females, 76; males, 70), TPs were 8.9 ± 1.6 mm apart. TP quality was graded into four categories based on the criteria of presence, interdomal crease, base width, and distinction. The distributions of TPs according to TPG were as follows: I, 12%; II, 50%; III, 30%; and IV, 8%. The TPG system was applied to a collection of photographs of female Caucasian magazine models, which had a distribution similar to that of the Caucasian females in the study population, demonstrating the effectiveness of grading. Surgical guidelines for the preservation and generation of TPs are presented, especially the geometric consequence of various surgical maneuvers, e.g., dome division and tip graft.
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