Management of the overprojected nose and ptotic nasal tip

Ensuring consistent and reproducible results during cosmetic tip rhinoplasty can be extremely difficult. The unpredictable forces of wound contracture and scarring have humbled even the most experienced rhinoplasty surgeons in various cases throughout their careers. Armed with a knowledge of tip dynamics, however, one can combat the various nasal tip deformities with reasonable accuracy. In this article, we present techniques that are specifically used to correct tip overprojection and tip ptosis. The medial crural tuck-up is a procedure that can be used to deproject the nose while maintaining an overall harmonious tip aesthetic. The lower to upper lateral cartilage suspension has been used in our practice to specifically modify the droopy nasal tip. Both procedures have produced excellent long-term results.