Case Details
Nasal Tip Work
The nasal tip is where a lot of the action lies. The very finest of outcomes usually have the very finest of nasal tip work. Nasal tip work is not always warranted, but it often marks the difference between a really refined looking nose and one that is less refined looking.
The symmetric nasal tip where the two dome cartilages come together and sit with harmony is the easier nasal tip to modify. So often, though, in the face of past trauma, the dome cartilages can become injured with resulting asymmetry and crookedness and a loss in supporting structure. These are the more difficult rhinoplasty surgeries because they involve precision, finesse, and an exactitude demanded by few other surgeries.
There are grafting techniques and suture-shaping techniques; there are onlay and batton and camouflage techniques; there is addition and subtraction, angulation and projection features. The nasal tip is a very 3-dimensional structure. We refer to the tip as a tripod, mimicking this structure, and by addressing different limbs of the tripod, we can effect different outcomes with nasal tip rhinoplasty.
With this lady, a prior trauma had buckled her dome cartilages in her nasal tip, creating a crooked and boxy nasal tip. The proportions of her nose were still excellent, and so bracing the sidewall to support a good airway and creating symmetry were the tasks that were prominent.
What a smile!
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