title: Dealing with the overprojecting pinched tip.
abstract: OBJECTIVE
  When reshaping the pinched and/or pointed nasal tip, the use of cartilage grafting and internal sutures has been proven to be an excellent tool when the skin is not too thin. A new technique in tip aesthetics is presented. Its surgical applications are discussed.
  
  
  METHODS
  A tip reshaping without cartilage grafting or internal stitching was performed on 355 patients with thin skin; 317 were female and 38 were male. The follow-up period ranged from 6 months to several years, with an average of 16 months.
  
  
  METHODS
  The closed approach was used. Parallel incisions on the alar cartilage have been made and alternate spicules of cartilage have been then excised to reduce the length of the arc of the cartilage and to reshape the tip.
  
  
  RESULTS
  The technique was effective in achieving aesthetic norms.
  
  
  CONCLUSIONS
  When dealing with a very thin skin, the pinched or pointed tip may sometimes need a different approach. The use of cartilage crafting or internal stitching for the reshaping of the tip, in those cases, is not obligatory.
authors.affiliation: Abbey Pines Hospital, Manchester, United Kingdom. cosmetic@london.com
authors.forename: Abderrahman
authors.initials: A
authors.lastname: Mounir
authors.forename: Edward
authors.initials: E
authors.lastname: Latimer-Sayer
mesh_terms: D000328:Adult; D002356:Cartilage / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055171:Nasal Cartilages / Q000601:surgery*; D009666:Nose / Q000601:surgery; D012225:Rhinoplasty / Q000379:methods*; D013536:Suture Techniques