Nasal Tip Aesthetics; Review article

Abstract

The nasal tip is one of the most important features of facial esthetics. The surgical anatomy of the nasal tip is determined by intrinsic factors, such as the nasal tip volume, shape, definition, and symmetry. These factors are intimately related to the morphology of the lower lateral cartilages and successful rhinoplasty depends on maintaining adequate nasal tip projection and rotation and their rule in nasal tip definition. Securing the position and shape of the nasal tip is one of the most challenging problems in rhinoplasty. There are two main parameters which contribute to the aesthetics and subsequently the definition of the nasal tip. They are projection and rotation. A patient needing nasal tip surgery may present with any of these parameters being abnormal in any combinations. Septal extension grafting is more reliable method of controlling tip projection, shape, and rotation, particularly in patients with weak lower lateral cartilages. Septal extension grafts are proposed as a way of redefining the skeletal relationship between the nasal tip and dorsum. Creating structural support for the tip complex based on the anterior septum allows for predictable control of tip projection and/or rotation particularly in noses characterized by a weak mid-vault, a plunging tip, and drawn-up alae.