Gradual Approach to Refinement of the Nasal Tip: Surgical Results

Abstract

Introduction: The complexity of the nasal tip structures and the impact of surgical maneuvers make the prediction of the final outcome very difficult. Therefore, no single technique is enough to correct the several anatomical presentations, and adequate preoperative planning represents the basis of rhinoplasty. Objective: To present results of rhinoplasty, through the gradual surgical approach to nasal tip definition based on anatomical features, and to evaluate the degree of patient satisfaction after the surgical procedure. Methods: Longitudinal retrospective cohort study of the medical charts of 533 patients of both genders who underwent rhinoplasty from January of 2005 to January of 2012 was performed. Cases were allocated into seven groups: (1) no surgery on nasal tip; (2) interdomal breakup; (3) cephalic trim; (4) domal suture; (5) shield-shaped graft; (6) vertical dome division; (7) replacement of lower lateral cartilages. Results: Group 4 was the most prevalent. The satisfaction rate was 96% and revision surgery occurred in 4% of cases. Conclusion:The protocol used allowed the implementation of a gradual surgical approach to nasal tip definition with the nasal anatomical characteristics, high rate of patient satisfaction with the surgical outcome, and low rate of revision. PALAVRAS-CHAVE

Three-Dimensional Cartilage Graft Technique

“…1,7,8 To provide a better definition of the nasal tip, every surgeon must have detailed information about the nose concepts including: reconstruction of nasal valves, choosing the cartilage type for grafts and meticulous surgical technique. Several techniques for nasal tip reconstruction have been described.…”

“…Several techniques for nasal tip reconstruction have been described. 1 The most prominent part of the face is the nose, the most prominent part of the nose is the nasal tip. For this reason, nasal tip projection has great importance.…”

“…The nasal tip has a complex structure due to the arrangement of the medial and lateral lower cartilage elements with variable skin thickness. 1 The evaluation of the nasal tip can be classified according to its definition, projection, and rotation. The thickness and structure of the skin and the nature of the subcutaneous tissue have a significant role in the degree of projection in the nasal tip.…”