Evaluation of Nasal Tip Definition in Closed Rhinoplasty

BACKGROUND Trends in rhinoplasty techniques have seen a significant shift from closed to open over the last decade.1,2 The ideal surgical approach for rhinoplasty continues to be debated amongst aesthetic surgeons. Each technique has its merits. Open rhinoplasty is deemed the procedure of choice in all but the simplest rhinoplasties, reserving the traditional closed approach for hump reduction cases due to reduced operative times and reduced swelling and scarring. However, even in minor “hump reduction” cases, we feel there may be aesthetic shortcomings using a simplistic traditional closed technique. A pattern, a poor tip definition, was noted in a series of closed rhinoplasty procedures. It was hypothesized that closed rhinoplasty performed to correct simple dorsal hump abnormalities leads to poor tip definition postoperatively in those that had preexisting tip abnormalities.