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Reconstructive Rhinoplasty
The 3-Dimensional Nasal Tip
Oren Friedman, MD;
Timur Akcam, MD;
Ted Cook, MD
Arch Facial Plast Surg. 2006;8:195-201.
Objectives To review nasal alar support mechanisms, introduce the concept of tractional forces on the nasal ala, and describe a reconstructive technique to correct nasal tip deformities associated with weakened tractional force on the nasal ala.
Design Photographic study and retrospective medical chart review.
Results We noted that patients with weakened support at the dome of the lower lateral cartilage had lateral alar deformities. Strengthening the cartilaginous deficiency improved the nasal appearance and function in 90% of patients.
Conclusions Deformities of the nasal tip are among the most difficult to correct. Tractional forces provided by dome strength help to maintain the ala in its normal anatomical position. Structural tip grafts restore the tractional force and, thereby, help to correct the alar deformity.
Author Affiliations: Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minn (Dr Friedman); the Department of Otolaryngology, Gulhane Military Medical Academy, Ankara, Turkey (Dr Akcam); and the Department of Otolaryngology, Oregon Health and Science University, Portland (Dr Cook).
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