A high, sharp nose exudes an aura of intelligence. But what if your nose doesn't meet your expectations? Nasal tip surgery is the most common procedure in rhinoplasty, offering many with imperfect nasal tips a chance for renewal. Below are different surgical approaches.
Nasal Tip Correction:
1. Cartilage Grafting Method:
An incision is made along the nasal margin inside the nostril or within the nasal cavity to expose the alar cartilage and lateral nasal cartilage. Depending on the situation, the cephalic portion of the alar cartilage or the caudal portion of the lateral nasal cartilage is excised. The harvested cartilage is sculpted and sutured to the apex of the nasal dome, elevating the nasal tip. Cartilage from the concha may also be harvested for grafting.
2. Bilateral Nasal Alar Cartilage Medial Foot Adhesion Technique:
Make bilateral incisions on the lateral sides of the columella to expose the medial feet of the alar cartilages and the nasal dome. Resect the soft tissue between the two medial feet, then perform a mattress suture near the upper and lower ends of each medial foot to bring them closer together.This technique elevates the nasal tip by 2-3mm.
3. Nasal alar base wedge resection:
For cases with a well-shaped but slightly low nasal tip, a wedge-shaped full-thickness tissue segment is excised from both nasal alar bases. This narrows the nostrils and elevates the nasal dome, thereby raising the nasal tip.
4. Hyper-elevated Nasal Tip Correction:
This rhinoplasty technique is suitable for nasal tips with excessive projection, specifically those exhibiting a flat, straight elevation from the nasal dorsum to the tip. Cases with significant curvature during elevation are termed hyper-elevated nasal tips. Surgical correction yields favorable outcomes.An incision is made between the cartilages, dissecting retrograde toward the caudal end of the alar cartilage's dome. The most prominent portion of the dome is partially excised through all layers, with the ends sutured together. The cartilage on both sides of the junction is incised intermittently in the superficial layer to weaken it, resulting in a sharp yet not overly pointed nasal tip.Resection may also be performed at the base of the medial crus of the alar cartilage, though this yields less favorable results than dome resection.Thickened nasal tip correction, termed tip reduction, presents the most challenging surgical approach for this condition. The procedure employs either a marginal incision or an intercartilaginous incision. The alar cartilage and lateral nasal cartilage are fully exposed and mobilized, with uniform excision of fibrofatty tissue from all relevant areas.Resect 1/2 to 2/3 of the lateral aspect of the alar cartilage head, then rotate the lateral crus medially and cephalad. This action will cause the alar base to retract. Make an interrupted incision through the cartilage at the dome of the alar cartilage without severing it.If reinforcing the nostrils or transverse nostrils fails to achieve verticalization, perform a wedge resection at the alar base. If the nasal tip lacks elevation, place the excised cartilage as a graft over the dome surface to elevate the tip.