title: Creating elegance and refinement at the nasal tip.
abstract: Enhancing nasal tip definition requires a three-dimensional approach encompassing both form and function. Dome refinements achieved during surgery should be created with sufficient integrity to withstand postoperative healing forces. Stabilizing the nasal base is the first component of dome alterations and prevents loss of tip rotation and projection. Structural grafting can be used to enhance tip definition and at the same time adds support to the cartilaginous framework. Tip shield grafts camouflage dome asymmetries, establish the tip-defining point, and enhance the supratip break. Shield grafts can be placed in all skin types with appropriate contouring and camouflaging techniques.
authors.affiliation: Facial Plastic and Reconstructive Surgery Unit, Lindsay House Center for Cosmetic and Reconstructive Surgery, 937 East Avenue, Rochester, NY 14607, USA. vquatela@quatela.com
authors.forename: Vito C
authors.initials: VC
authors.lastname: Quatela
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Kolstad
mesh_terms: D002356:Cartilage / Q000637:transplantation*; D006801:Humans; D055171:Nasal Cartilages / Q000601:surgery; D009300:Nasal Septum / Q000601:surgery; D009666:Nose / Q000601:surgery*; D012225:Rhinoplasty / Q000379:methods*