Nasal Tip Plasty

 622. <Nasal Tip Plasty>

Nasal tip plasty is a type of rhinoplasty performed when the shape of the nasal tip is unsatisfactory—such as when it appears bulbous, droopy, upturned, crooked, too high, or too low. The goal is to create a more natural or refined nasal tip.

There are two main approaches: closed and open. While synthetic implants are sometimes still used for the nasal bridge, autologous tissue (like ear cartilage, septal cartilage, or rib cartilage) is increasingly preferred for the nasal tip to avoid complications like implant extrusion or infection.

Closed nasal tip plasty includes:

1. A minimal incision to insert an implant, sometimes with added dermal grafts or ear cartilage.

2. The "closed-open" method (closed exposure rhinoplasty), where the entire tip cartilage is exposed through internal incisions without cutting the columella.

Open rhinoplasty involves incising the columella, providing full visibility of the nasal tip structures. This is useful in complex cases, but should be avoided unless necessary due to the risks of visible scarring and disruption to the columellar artery, which can reduce blood supply and increase the risk of tip necrosis—especially if lateral nasal arteries are also damaged during surgery.

When the nasal tip is short, it may be corrected by inserting cartilage between the lower and upper lateral cartilages to lower the nostrils. If the tip is long, cephalic trimming (removing upper part of the lower lateral cartilage) can lift it. Bulbous tips may require fat removal, while overly pointy tips can be softened with micro-fragmented cartilage grafts.

To support or project the tip, autologous cartilage—such as ear, septal, or rib cartilage—is used. While septal cartilage may be insufficient in many Asian patients due to low nasal bridges, overharvesting ear cartilage can deform the ear. Rib cartilage, while initially firm, softens over time due to metaplasia, making it a reliable option for long-term shaping.

For large noses, tip cartilage is reduced; for small noses, grafts are added. Rib cartilage can serve both tip and bridge reconstruction using grafts and particles, making it an all-in-one solution.

[Nasal tip plasty aims to refine or reshape the nasal tip using grafts or sculpting for a natural or elegant appearance.]

– 622mm Growth Pine Tree –

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