Primary nasal tip surgery : a conservative approach

BACKGROUND: Rhinoplasty and rhinoseptoplasty are very important and complex surgical procedures because the nose plays a pivotal aesthetic role in the face and an important functional role in breathing. Mild bulbous, plunging, undefined tips are very common, and tip refining and repositioning often are required surgical procedures. METHODS: For 97 selected patients, the authors performed their personal technique consisting of a transcartilaginous approach, incomplete vertical interruption, and retrograde undermining of the lower lateral cartilages to improve tip projection and definition. The five aspects analyzed were nasal tip symmetry, nostril symmetry, tip projection, tip definition, and appearance of the nasal tip only. Each parameter was assessed using pre- and postoperative quantification according to a visual analog scale. Postoperative evaluation was performed during a mean follow-up period of 1 year. RESULTS: The results at 1 year showed high rates of improvement in tip definition (mean, 7.9 ± 2.4) and nasal tip only evaluation (mean, 6.5 ± 3.1). The patients reported an improvement in nasal tip symmetry (mean, 4.2 ± 3.2), nostril symmetry (mean, 4.5 ± 4.1), and tip projection (mean, 5.8 ± 2.9). CONCLUSIONS: This simple, safe, and effective technique is proposed for mild bulbous, plunging, undefined, and hypoprojected tips