title: Tip rhinoplasty--a modified delivery approach.
abstract: BACKGROUND
  For many cases of tip surgery a delivery approach is selected. If the patient has long alar cartilages, it may be difficult to deliver the cartilages without twisting or tearing the domes. In such a patient, a modified delivery approach may be easier to perform.
  
  
  METHODS
  For the modified delivery approach a transcartilaginous incision is first made and cephalic resection of the alar cartilage is performed. Then a marginal incision is made, and the remaining alar cartilage is dissected and easily delivered. After both alar cartilages being delivered, they are compared, and, if necessary, further resection is done in order to achieve perfect symmetry or to achieve the desired size of the cartilages. The cartilages may then be grafted, sutured or modified as considered necessary.
  
  
  RESULTS
  We have been using the modified delivery approach for the last five years and we have had no complications of the technique itself. Two patients operated on by using this approach are presented.
  
  
  CONCLUSIONS
  We believe that, in patients with long alar cartilages and a wide nasal tip, this modification turns the delivery approach into an easier and safer approach.
authors: Hospital da Arrábida, Porto, Portugal. rjxavier@iol.pt
authors: Rui
authors: R
authors: Xavier
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D055171:Nasal Cartilages / Q000601:surgery; D012225:Rhinoplasty / Q000379:methods*; D016896:Treatment Outcome