New surgical concept described for nasal tip recontouring

(HealthDay)—A series of cases have demonstrated how maneuvers typically reserved for the open rhinoplasty approach can be combined with minimally invasive endonasal rhinoplasty techniques for effective nasal tip recontouring, according to research published online Nov. 19 in the Archives of Facial Plastic Surgery.

Holger G. Gassner, M.D., of the University of Regensburg in Germany, and colleagues describe a novel surgical concept for nasal tip surgery which was performed in 100 patients and involved complete dissection and delivery of the lateral crus; dome repositioning; placement of alar strut grafts that extend medially; and lateral advancement of the lateral crus.

The researchers found that 92 patients were completely satisfied with the entire appearance of the nose; four were satisfied, and declined revision for minor imperfection; and four requested revision for cosmetic imperfection. Of the eight imperfections, six were dorsal irregularities and two were nasal tip asymmetries. Few patients were not satisfied with the feel to touch and softness of the nose (17 after three months; two after 12 months). One patient had a need for nasal packing and three required revision for persistent nasal obstruction.

"The present report does not claim to designate a new operation. It rather presents a combination of established techniques that form—to our knowledge—in some regards a novel concept to approach and correct the nasal tip," the authors write. "We feel that the concept of nasal tip recontouring through the endonasal complete release approach is shown to generate naturally soft nasal tips and excellent cosmetic and functional results in the young female primary rhinoplasty patient population."

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