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Plastic and Reconstructive Surgery

The Two Essential Elements for Planning Tip Surgery and Primary and Secondary Rhinoplasty:
Observations Based on Review of One Hundred Consecutive Patients

Mark B. Constantian, MD

Nasal tip surgery has become significantly more complex since the introduction of tip grafting and the many suture designs that followed the resurgence of open rhinoplasty. Independent of the surgeon's technical approach, however, is the need to identify the critical anatomical characteristics that will make nasal tip surgery successful. It is the author's contention that only two such features require mandatory preoperative identification: (1) whether the tip is adequately projecting and (2) whether the alar cartilage lateral crura are orthotopic or cephalically rotated ("malpositioned"). Data were generated from a review of 100 consecutive primary rhinoplasty patients on whom the author had operated. The results indicate that only 33% of the entire group had adequate preoperative tip projection and only 54% . . . [Full Text of this Article]