Summary :
External Transcolumellar Approach
Other surgical approaches
Deviated noses
Augmentation rhinoplasty
Functional graft
Graft of the nasal tip
Secondary rhinoplasties

Chap VII - Graft of the Nasal Tip and Columella


One of the objectives of the nasal tip surgery is to create harmony of Contour, Position and Projection of the nasal tip with the other " volumes " of the nasal pyramid ; most often the surgeon's goal is to obtain :a nasal tip which stands out from the dorsal line by 2 or 3 mm and a sligthly convex columella-lobular profile.

Difficult cases are seen in patients who presents with a short columella , weak and non resilient alar cartilages , thick skin and a substantial cartilaginous hump . In such a case , after lowering the anterior septal border in an incrementally , a supra-tip deformity may develop, because the poorly projecting tip lacks the strenght to project over a lowered dorsum.

Fig. 1 : A shield graft (Sheen) placed in the infratip segment may provide augmentation of the tip projection and an improvment of teh tip contour

Fig. 2 : Nasal tip has been refined by minimal resections of the alar cartilages and by a Tip cartilage graft

The doctors AIACH and DURON are specialists in plastic surgery of the nose in Paris