Aesthetic Plastic Surgery

, Volume 37, Issue 1, pp 16–21 | Cite as

Nasal Tip Plasty: The Delivery Approach Revisited

Original Article Aesthetic

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.

Level of Evidence V

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Keywords

Delivery approach Approaches for rhinoplasty Rhinoplasty 

References

  1. 1.
    Tardy ME (2004) Contemporary rhinoplasty: principles and philosophy. In: Behrbohm H, Tardy ME (eds) Essentials of septorhinoplasty. Thieme, Stuttgart, pp 37–63Google Scholar
  2. 2.
    Nolst-Trenité GJ (2005) Basic approaches and techniques in nasal tip surgery. In: Nolst-Trenité GJ (ed) Rhinoplasty, 3rd edn. Kugler, The Hague, pp 87–96Google Scholar
  3. 3.
    Nolst-Trenité GJ, Vinayak BC (2005) External rhinoplasty: the benefits and pitfalls. In: Nolst-Trenité GJ (ed) Rhinoplasty, 3rd edn. Kugler, The Hague, pp 125–141Google Scholar
  4. 4.
    Nolst-Trenité GJ (2009) Surgery of the nasal tip: intranasal approach. In: Papel ID (ed) Facial plastic and reconstructive surgery. Thieme, Stuttgart, pp 563–576Google Scholar
  5. 5.
    Xavier R (2009) Tip rhinoplasty—a modified delivery approach. Rhinology 47:132–135PubMedGoogle Scholar
  6. 6.
    Xavier R (2013) A modified delivery approach. In: Shiffman MA, Di Giuseppe A (eds) Advanced aesthetic rhinoplasty: art, science, and new clinical techniques. Springer, BerlinGoogle Scholar
  7. 7.
    Vuyk HD, Zijlker TD (2005) Open-tip rhinoplasty. In: Nolst-Trenité GJ (ed) Rhinoplasty, 3rd edn. Kugler, The Hague, pp 115–123Google Scholar
  8. 8.
    Adamson PA, Litner JA (2009) Open rhinoplasty. In: Papel ID (ed) Facial plastic and reconstructive surgery. Thieme, Stuttgart, pp 529–546Google Scholar
  9. 9.
    Whitaker E, Johnson C Jr (2003) The evolution of open structure rhinoplasty. Arch Facial Plast Surg 5:291–300PubMedCrossRefGoogle Scholar
  10. 10.
    Farrior E (1999) Dramatic refinement of the nasal tip. Otolaryngol Clin North Am 32:621–636PubMedCrossRefGoogle Scholar
  11. 11.
    Tardy ME, Toriumi DM, Hecht DA (2009) Philosophy and principles of rhinoplasty. In: Papel ID (ed) Facial plastic and reconstructive surgery. Thieme, Stuttgart, pp 507–528Google Scholar
  12. 12.
    Gassner HG, Sherris DA, Friedman O (2009) Rhinology in rhinoplasty. In: Papel ID (ed) Facial plastic and reconstructive surgery. Thieme, Stuttgart, pp 489–506Google Scholar
  13. 13.
    Han SK, Lee DG, Kim JB, Kim WK (2004) An anatomic study of nasal tip supporting structures. Ann Plast Surg 52:134–139PubMedCrossRefGoogle Scholar
  14. 14.
    Han SK, Ko HW, Lee DY, Kim WK (2005) The effect of releasing tip-supporting structures in short-nose correction. Ann Plast Surg 54:375–378PubMedCrossRefGoogle Scholar
  15. 15.
    Kim DW, Toriumi DM (2004) Open structure rhinoplasty. In: Behrbohm H, Tardy ME (eds) Essentials of septorhinoplasty. Thieme, Stuttgart, pp 117–135Google Scholar

Copyright information

© Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2013

Authors and Affiliations

  1. 1.Hospital da ArrabidaPortoPortugal
  2. 2.PortoPortugal

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