title: Reconstructive rhinoplasty: the 3-dimensional nasal tip.
abstract: 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.
authors.affiliation: Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minn 55905, USA. friedman.oren@mayo.edu
authors.forename: Oren
authors.initials: O
authors.lastname: Friedman
authors.forename: Timur
authors.initials: T
authors.lastname: Akcam
authors.forename: Ted
authors.initials: T
authors.lastname: Cook
mesh_terms: 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