“Suture” techniques in nasal tip reconstruction

Ever since Sushruta laid the foundations of rhinoplasty for the first time in ancient India, a lot of thought and effort has gone into developing the techniques that we know today. Tip plasty is an essential and indispensable part of rhinoplasty. It is important to realise that every nose is different and the attention to fine details is important and defines a good rhinoplasty surgeon. Every rhinoplasty is different and tailor-made to the requirements of the patient. Nasal tip reconstruction is a complex subject, particularly in posttraumatic noses and compliments the operative work on nasal dorsum. The aims of nasal tip plasty are to achieve patient satisfaction with both function and cosmesis. We should aim to achieve: 1. Good definition and symmetry of the nasal tip. 2. Adequate projection of the nasal tip. 3. Adequate rotation of the tip in relation to the dorsum. Following a pre-operative assessment, the surgeon aims to reconstruct the tip by changing the definition, projection or rotation. Due consideration should be given to the final appearance and position of the tip in relation to the dorsum of the nose, taking into account the skin thickness, race and ethnic variations. TIP SUPPORT MECHANISMS