Gradual Approach to Refinement of the Nasal Tip: Surgical Results

Abstract

Objectives:

The complexity of the nasal tip structure and the impact of surgical holder maneuvers makes prediction of the final outcome very difficult. Therefore, no technique alone is enough to correct the numerous anatomic presentations adequately being the preoperative planning, the basis of rhinoplasty. This study’s aim is to present results of rhinoplasty, by gradual surgical approach to nasal tip definition based on anatomic features, and evaluate the degree of satisfaction of patients after the surgical procedure.

Methods:

A retrospective historical cohort study of the medical charts of 533 patients of both sexes who underwent rhinoplasty from January 2005 to January 2012. Cases were allocated into 7 groups: (1) no surgery on nasal tip, (2) interdomal breakup, (3) cephalic trim, (4) domal suture, (5) shield-shaped graft, (6) vertical dome division, and (7) replacement of lower lateral cartilages.

Results:

Group 4 was the most prevalent. The satisfaction rate was 96%, and revision surgery occurred in 4% of cases.

Conclusions:

The protocol used allowed the association of the gradual surgical approach to nasal tip definition with the nasal anatomic characteristics, high rate of satisfaction with the surgical outcome, and low rate of revision.