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C. W. David Chang, MD; Robert L. Simons, MD

Arch Facial Plast Surg. 2008;10(2):88-92.

Objectives  To discuss overprojected and broad nasal tips, to overview treatment options, and to relate our experience with the hockey-stick technique.

Design  A retrospective review (1975-2005) was conducted. Patients were selected from a computerized rhinoplasty database of operative cases. The database was used to extract a subset population that had received the hockey-stick tip procedure and had follow-up data for 1 year or more after surgery. Medical records and photographs were also analyzed in this review of results and complications.

Results  The hockey-stick modification of vertical dome division was used in 137 patients (9.9% of the rhinoplasties in the computerized database). Of these, 64 patients had 1 year or more of follow-up. Complications referable to the nasal tip (eg, bossae, persistent tip projection, and alar asymmetry) were seen in 8 patients (13%). Revisions for tip-related problems were performed in 4 patients (6%).

Conclusions  The hockey-stick technique is an effective method for nasal tip deprojection and narrowing via an endonasal approach. The length of follow-up in this patient population allows good long-term evaluation of this technique.

Author Affiliations: Departments of Otolaryngology–Head and Neck Surgery, University of Missouri, Columbia (Dr Chang), and University of Miami, Miami, Florida (Dr Simons); and MIAMI Institute for Age Management and Intervention, Miami (Dr Simons).