The foundation and support of the nasal tip are based on the shape, strength, and location of the lower lateral cartilages (LLC) as well as their association with the ligaments. In addition, the nasal tip is supported by the upper lateral nostril cartilage, septum, base, and pyriform aperture. Before surgery, an examination may shed light on nasal tip deformities, including primary and/or other imbalances. Iatrogenic injury to the nasal tip may reduce structural support. In addition, cephalic pruning of the LLCs, resection, dorsal reduction, nasal incisions, and/or base resections may contribute to a significant loss in tip protrusion. Open rhinoplasty may also result in tip diminution upon soft tissue disruption. The approach is important to surgically expose the skeletal structures. Open or closed surgical methods are useful for tip rhinoplasty. The selection is strategic and is based on the difficulty and the surgeon’s expertise. Non-delivery or delivery approaches are achieved. In the delivery approach, the soft tissue is removed from the cartilage, and the technique is repeated on the contralateral side. In external rhinoplasty, cephalic trim, columellar strut graft, tip refinement, grafts septal extension graft, lateral crural strut, and alar contour grafts are chosen. In this chapter, nasal tip surgery is discussed.
KeywordsNasal tip surgery Rhinoplasty Non-delivery approach Delivery approach Cephalic trim Columellar strut graft Tip refinement
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