Resumo

RODRIGUEZ-CAMPS, S.. A new technique to treat the very difficult nasal tip: A 22 year experience (1987-2009). Cir. plást. iberolatinoam. [online]. 2010, vol.36, n.1, pp.3-12. ISSN 1989-2055.

There are many ways to remodel and embellish a nasal tip. At times, we cannot find the way without eliminating all the excess, that is, nasal tip surplus. And this may be the case in primary or secondary rhinoplasty. At first, it seems that everything can be relaid and remodelled, yet sometimes when we uncover the tip, we discover that the reality is a mass of broken or bowed cartilages which are hard to put right. For this reason in 1987 we began to remove all the alar cartilages in one secondary rhinoplasty case with a totally unattractive look. The result after one year was correct from the aesthetic and functional viewpoint, and it still looks right. There was no collapse with nasal respiratory failure and, aesthetically, the shape was maintained. We covered the crus medialis with a small 2-layered temporal fascia patch. From this point onwards, and only in very special cases, we proceed as follows: total amputation of the alar cartilages, including the domes, or the domes are maintained by preserving the fibre-adipose tissue of the tip by suturing at the centre of the extreme crus medialis and covering it with temporal fascia, depending on the thickness of the skin on the tip. This technique is mainly indicated for secondary rhinoplasty with completely destroyed cartilages of the nasal tip and for certain primary rhinoplasty cases of excessively wide and bulbous nasal tip, but always using open rhinoplasty. Our philosophy is, therefore, refinement and beauty for the nasal tip with a solid, equilateral base... No prejudices, no taboos.

Palavras-chave : Rhinoplasty; Nasal Tip; Alar Cartilages; Temporal Fascia.

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