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An Overview about Techniques to Support Nasal Tip and Control Position

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Mohammed Salah Awad, Ahmed Mohammed Ali, Ahmed Abo-Hashem Azab, Mona Galal Salah Ahmed
» doi: 10.53555/ecb/2023.12.Si12.342

Abstract

Background: Support for the nasal tip is derived from a combination of bony, cartilaginous, and soft tissue structures. Bone of the midface provides the foundation for nasal support. Medially, the maxillary crest serves as a buttress for the nasal septum. The septum in return provides crucial support for the external nose and nasal tip. Soft tissue attachments from the dorsal and caudal septum to the lower lateral cartilages have a direct influence on tip support and location. Laterally, soft tissue attachments connect the lower lateral cartilage complex to the bony piriform aperture. The lower lateral cartilages are considerably supported by the dorsal and caudal septum. Lower lateral cartilage shape, location, and integrity are crucial for the appearance and function of the nasal tip and external nasal valves. Each lower lateral cartilage is composed of a medial crus, middle crus, and lateral crus. The outward appearance of the nasal tip is governed by the features of these crura and the soft tissue connections to neighboring structures. Facial analysis transforms the aesthetic appearance of the face into its underlying anatomical features. The surgeon can precisely establish the structure underneath the SSTE through careful visual and tactile examination. The anatomy can be palpated to determine the strength of the underlying framework. This analysis enables the surgeon to predict structural defects and arrange the necessary modifications to obtain the desired results for the patient. The objective of the following techniques is to control the position of the nasal tip relative to the alar facial groove. It must be remembered, however, that tip projection is only one parameter, one must allow for changes in tip rotation or shape of the alar cartilages. Surgical techniques for nasal projection have evolved from those often described as destructive to those favoured for sparing the integrity of the alar cartilage.

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