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Published on: January 23, 2026
Transfixion incision as an initial technique in nasal tip deprojection
Philip Solomon1, Richard Rival, Aimee Mabini
1Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario.
Summary
Transfixion incision alone can effectively reduce an overprojected nasal tip. Thinner skin types achieve greater deprojection, suggesting a graduated surgical approach for rhinoplasty.
Area of Science:
- Plastic Surgery
- Facial Aesthetic Surgery
Background:
- Overprojected nasal tip is a common rhinoplasty challenge.
- Transfixion incision's efficacy alone for nasal tip deprojection is not well-established.
Purpose of the Study:
- To evaluate transfixion incision as a standalone method for nasal tip deprojection.
- To assess the influence of skin thickness on deprojection outcomes.
Main Methods:
- Seventy-two patients seeking nasal tip deprojection underwent transfixion incision.
- Patients were classified by skin thickness (thin, medium, thick).
- Deprojection results were compared across skin thickness groups.
Main Results:
- Transfixion incision alone yielded a mean nasal tip deprojection of 1.6 mm.
- Thin-skinned patients showed significantly greater deprojection (mean 2.12 mm) compared to others.
- No significant difference in deprojection was observed between medium and thick-skinned groups.
Conclusions:
- Skin thickness is a relevant factor in planning nasal tip deprojection.
- Transfixion incision alone provides comparable deprojection to combined methods, especially in thin-skinned individuals.
- A graduated approach, starting with transfixion incision, is recommended for rhinoplasty.
