This article presents a contemporary overview of tip suturing and tip structural grafting techniques used to refine the wide nasal tip. Previous reductive techniques have proved to produce unnatural results over time. It is imperative to correctly evaluate the nose and assess all possible pitfalls during the preoperative period before outlining a surgical plan. Intraoperatively, an algorithmic approach helps obtain a reproducible and refined yet properly narrowed domal tip region with graceful contours that extend laterally to the alar lobule with proper shadowing.
Key points
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The ideal nasal tip is achieved when there is a balanced interaction between the soft tissue covering and underlying nasal framework.
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Contouring maneuvers that establish, and maintain, aesthetically pleasing highlights and shadowing around the nasal tip region are mandatory for the overall balance of a truly refined nasal appearance.
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Comprehensive management of the broad nasal tip requires maneuvers that allow for a favorable contour extending from the lateral dome region to the alar margins.
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Surgical changes to the nasal framework dynamically alter the relationship between the tip structures, dorsum, and overlying soft tissues and must be evaluated preoperatively and intraoperatively to direct surgical maneuvers.
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