Correction of the supratip deformity of the nose.

BACKGROUND A supratip deformity can develop either congenitally or after a poorly executed rhinoplasty, as a result of fullness or convexity just above the nasal tip. OBJECTIVE In this article, the authors describe the causes of the supratip deformity and present their technique for surgical correction. METHODS A retrospective chart review was conducted for 62 consecutive patients (24 primary rhinoplasty and 38 secondary rhinoplasty) treated between January 2005 and February 2010. The authors' approach to managing supratip deformity included a combination of wide undermining of the nasal skin through the open technique; resection of excessive soft tissue and the bony, cartilaginous dorsum; suturing to advance the supratip; and augmentation of the nasal tip and dorsum with cartilage, crushed cartilage, silicone implants, and/or septal extension grafts. RESULTS No infection or nasal bleeding was recorded during postoperative follow-up. The supratip and tip projection showed adequate shape in all cases. To assess satisfaction, all patients and 2 independent plastic surgeons were asked to rate the result on a 5-point scale. The average patient satisfaction rating was 4.2 and the average independent rating was 4.4 points. CONCLUSIONS Supratip deformities should be corrected according to their unique cause and shape. The authors' method of repairing these deformities has resulted in a low complication rate and yielded satisfactory results.