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Rhinoplasty Dissection Manual » Appendix E – Tip Support, Incisions, and Approaches

Appendix E – Tip Support, Incisions, and Approaches

MAJOR TIP-SUPPORT MECHANISMS

Size, shape, and strength of lower lateral cartilages

Medial crural footplate attachment to caudal septum

Attachment of caudal border of upper lateral cartilages to cephalic border of lower lat­eral cartilages

[Nasal septum also is considered a major support mechanism of the nose.[ MINOR TIP-SUPPORT MECHANISMS

Ligamentous sling spanning the domes of the lower lateral cartilages (i.e., interdomal ligament)

Cartilaginous dorsal septum

Sesamoid complex of lower lateral cartilages

Attachment of lower lateral cartilages to overlying skin/soft-tissue envelope

Nasal spine

Membranous septum

INCISIONS: METHODS OF GAINING ACCESS

Intercartilaginous

Transcartilaginous

Marginal (NOT to be confused with rim incision)

Transcolumellar

APPROACHES: PROVIDE SURGICAL EXPOSURE

Cartilage-splitting

Retrograde

Delivery: Marginal + intercartilaginous incision

External approach: Marginal + transcolumellar incision

SCULPTING TECHNIQUES: SURGICAL MODIFICATIONS

Complete strip (i.e., cephalic resection) or volume reduction of lateral crura

Incomplete strip (dome division)

Transdomal/domal sutures

Augmentation grafting

Tip graft

Other

REFERENCES

  1. Tardy ME. R/tinoplasly: the art and the science. Philadelphia : WB Saunders, 1997.
  2. Tardy ME, Toriumi DM. Philosophy and principles of rhinoplasty. In: Cummings C.W. Fredrickson JM, Harker LA, et al., eds. Otolaryngology: head & neck surgery. 2nd ed. St. Louis : Mosby Year Book. 1993: 278-294.

Related Information:

  • Achieving Surgical Goals: Selected Options
  • Acknowledgements
  • Adjunctive Procedures
  • Aesthetic Analysis
  • Alar Base Resection
  • Alar Wedge Excision
  • Anatomy
  • Chapter 10 – Sliding Alar Flap
  • Chapter 11 – Caudal Extension Grafts
  • Chapter 13 – Placement Of Intranasal Packs, Nasal Splint
  • Chapter 13 – Postoperative Care
  • Chapter 5 – Incisions and Approaches
  • Cleft Lip Nasal Deformity
  • Closure of the Marginal
  • Delivery Approach
  • Deviated Caudal Septum
  • Foreward
  • Guide to Nasal Analysis
  • Harvesting Calvarial Bone
  • Harvesting Conchal Cartilage: Anterior Approach
  • Harvesting Ethmoid Bone
  • Harvesting Rib Graft
  • Indications For External Rhinoplasty Approach
  • Infiltrative Anesthesia Technique
  • Intermediate Osteotemies
  • Lab Exercise: Nasal Analysis
  • Landmarks For Analysis
  • Lateral Osteotoniies And Infracture
  • Appendix M – List of Selected Companies with Address/Phone Numbers
  • Medial Osteotoniies
  • Nasal Dissection: Septoplasty with Cartilage Harvest
  • Photography Setup (1)
  • Plumping Grafts
  • Preface
  • Rhinoplasty
  • Rhinoplasty Analysis
  • Rib Cartilage Graft Reconstruction of Saddle Deformity
  • Selected Complications of Rhinoplasty
  • Spreader Grafts
  • Suggested Surgical Instruments for Rhinoplasty
  • Surface Angles
  • Surface Angles, Planes, and Measurements
  • Surgery of the Nasal Tip
  • Tip Support, Incisions, and Approaches
  • Transcartilaginous or Cartilage-Splitting Approach
  • Tripod Concept

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RHINOPLASTY EDUCATION

  • Nose Form & Function
  • A Patient’s Guide
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  • Revision Rhinoplasty Textbook
  • Rhinoplasty Education
  • Rhinoplasty Dissection Manual

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"Dr. Daniel Becker is the sweetest most caring person. It’s almost a year since I had a really bad nose bleeds and he was there for us, came to hospital in the snow on a Sunday just to fix me. He is so very special and always there when you need him. Love him!!!"
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