Abstract
Most of the reshaping techniques for a blunt, bulbous nasal tip reduce the curvature and surface area of tip lobule cartilage, and they reform the tip to add definition. Unfortunately, the assemblage of surgical maneuvers frequently reduces valued projection, and it may result in an unnatural tip formation with a distasteful pattern of contracture. Employing the Isis cruraplasty allows incremental tip enhancement and narrowing, while restoring or preserving the natural configuration. After lateral dome division and undermining of the medial portion of the lateral crus, the lateral segment of the lateral crus was transected incrementally and advanced to reenforce the deficiency in rim support. Sewing the medial flanges together created a cartilaginous platform that supported the Isis graft, and/or it accommodated a columellar strut, if indicated. The Isis cruraplasty conserves virtually all of the lower lateral cartilage without compromising the potential for tip reshaping and augmentation.
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