Creating Elegance and Refinement at the Nasal Tip

Abstract

Enhancing nasal tip definition requires a three-dimensional approach encompassing both form and function. Dome refinements achieved during surgery should be created with sufficient integrity to withstand postoperative healing forces. Stabilizing the nasal base is the first component of dome alterations and prevents loss of tip rotation and projection. Structural grafting can be used to enhance tip definition and at the same time adds support to the cartilaginous framework. Tip shield grafts camouflage dome asymmetries, establish the tip-defining point, and enhance the supratip break. Shield grafts can be placed in all skin types with appropriate contouring and camouflaging techniques.

Nasal Profile Hump Reduction Using the Let-Down Technique

“…As previously described by the author, the influence of the let-down technique on midface allows a statistically significant increase in the malar contour by the mobilization of soft tissues adjacent to the nasal pyramid, and thus filling favorably and naturally this area, giving patients a better facial balance. 11 The goal of a dorsal-preservation technique is to keep intact the K-area above the septum and the entire osseocartilaginous vault. The dorsal hump can be eliminated and no irregularities or discontinuity should be found either by the patient or the surgeon.…”

“…A stable nasal base is the most important force preventing recurrent ptosis of the lower third of the nose. 11 The analysis of a patient undergoing nasal surgery should not only be of the nose; it is important to consider its race, to make an integral facial analysis and to determine the positive and negative facial characteristics to adequately diagnose the condition and take into account the technique to be used, which in addition to correcting the main problem, will give additional contributions to optimize the results. 15 In addition to having the anatomical-functional concepts, the nose should be viewed as a comprehensive structure both functionally and esthetically.…”