Reconstructive rhinoplasty: the 3-dimensional nasal tip.
OBJECTIVE
To review nasal alar support mechanisms, introduce the concept of tractional forces on the nasal ala, and describe a reconstructive technique to correct nasal tip deformities associated with weakened tractional force on the nasal ala.


METHODS
Photographic study and retrospective medical chart review.


RESULTS
We noted that patients with weakened support at the dome of the lower lateral cartilage had lateral alar deformities. Strengthening the cartilaginous deficiency improved the nasal appearance and function in 90% of patients.


CONCLUSIONS
Deformities of the nasal tip are among the most difficult to correct. Tractional forces provided by dome strength help to maintain the ala in its normal anatomical position. Structural tip grafts restore the tractional force and, thereby, help to correct the alar deformity.
Friedman
Oren
O
Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minn 55905, USA. friedman.oren@mayo.edu
Akcam
Timur
T
Cook
Ted
T
D000328:Adult; D000368:Aged; D002356:Cartilage / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009667:Nose Deformities, Acquired / Q000601:surgery; D009669:Nose Neoplasms / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D016896:Treatment Outcome