TechniqTueips

Abstract

Tip surgery remains the most discussed and least understood aspect of the rhinoplasty operation. The foundation of tip surgery is the interrelated “3 As” of anatomy, aesthetics, and analysis. The six tip characteristics of volume, width, definition, projection, rotation, and shape will be related to the underlying anatomy and overlying surface aesthetics. The surgeon will learn to distinguish the intrinsic tip from the lobule, as well as the influence of intrinsic and extrinsic factors on the tip itself. Then, in perhaps the most controversial aspect of this book, I will present only two tip operations, albeit with numerous variations. The operations are open tip suture and open tip graft. With these two operations, the surgeon can correct 95% of primary tip deformities. Each step in the procedure will be presented in great detail and must be mastered by the reader. Rather than try every tip operation available, the novice surgeon has the luxury of mastering only two interrelated procedures, thus achieving a greater understanding of surgical cause and effect. This chapter will serve as the foundation for all tip surgeries. Additional applications to a wide range of specific tip deformities are discussed throughout the book, especially in Chapter 8 and Chapter 9.