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Write a short note on nasal tip-plasty/ What are different surgical approaches to nasal tip? What are the indications of nasal tip surgery? What are the complications of nasal tip surgery?

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Tip-plasty is surgical surgical procedure performed for deformity of tip of nose with intervention on the roof.

The various surgical approaches to the nasal tip includes the following:

  1. Cartilage-splitting approach
  2. Tip delivery approach
  3. Retrograde approach
  4. External rhinoplasty

To achieve tip definition and refinement, it is necessary to narrow nasal tip. The various methods include:

  1. Removal of cephalic strip of the lower lateral cartilage
  2. Vertical division ± strip excision of lower lateral cartilage
  3. Tip suturing
  4. Tip grafting
  • Approximately 10 mm of lower cartilage should be left insitu to avoid buckling of the cartilage with the formation of bossae.
  • The lateral part of the lower lateral cartilage is left intact to maintain the integrity of the nasal valve.

INDICATIONS OF TIP-PLASTY:

The following are the indications of tip plasty:

  1. Correction of the over projecting tip: Medial and lateral vertical segment excision is done by transfixation incision/ Goldman vertical dome division.
  2. Correction of under projecting nasal tip: Goldman tip-plasty/ only graft/ lateral crus steal/shield graft
  3. Management of box shaped or broad nasal tip

COMPLICATIONS OF TIP-PLASTY:

The complications of tip plasty includes:

  1. Polybeak deformity
  2. Retracted ala
  3. Alar asymmetry
  4. retracted columella
  5. Bossae formation

 

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