Shaping and positioning the nasal tip without structural disruption : a new, systematic approach

摘要: This paper presents a new, comprehensive, and systematic approach to analysis, planning, techniques of primary nasal tip rhinoplasty, emphasizing that limit uncontrollable variables before proceeding which increase risk secondary deformity, including (1) maintenance structural integrity the alar rim strips, limiting use scoring or morselization reduce support introduce potential deformities, (2) shaping positioning lateral medial crura in reversible, nondestructive manner using permanent suture nonvisible control graft techniques, (3) minimizing postoperative by decreasing need for visible grafts shape complex achieving same results with existing elements, (4) integrating these concepts specific sequences surgical techniques—bilateral arch components individually positioned, then shaped unified symmetry, finally positioned rotation projection—and (5) introducing an integrated set sequencing surgery achieve objectives listed above most some rhinoplasties. The this are based on principle preservation elements (medial crural elements) preserves reduces incidence deformities (kinking, buckling, discontinuity) can result from disrupt integrity. If be achieved placement (with their additional variables) is greatly reduced. Shaping performed incrementally reversibly without jeopardizing process. Ten fresh cadaver dissections were utilized development techniques. A total 233 rhinoplasties (220 13 secondary) 1 9 years follow-up have been approach. Only two procedures deformity performed.