Tip Introduction and Anatomy

Abstract

Surgical manipulation of the nasal tip is the most challenging area of reconstruc- tive rhinoplasty. The elegantly complex anatomic form of the lower lateral carti- lages framed by the draping soft tissue of the alar and nostrils is so exquisitely balanced that it is very difficult to correct, once an iatrogenic mistake has been made. These structures are particularly sensitive to the complexities of scarring, which can act to cause contour depressions and hypertrophic convexitites. The intense pulling and distortion of these delicate cartilaginous and soft tissues by the scar contracture itself often leaves some residual permanent deformity, even after the best of reconstructive efforts.

Correction of these iatrogenic deformities will be discussed next in logical out- line, beginning with minor deformities and ending with the major reconstructions.