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Updated: May 16, 2026
Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Nasal tip recontouring in primary rhinoplasty: the endonasal complete release approach
Holger G Gassner1, Uwe Mueller-Vogt, Jürgen Strutz
1Division of Facial Plastic Surgery,Department of Otorhinolaryngology, University of Regensburg, Regensburg, Germany.
Objective:
Surgery of the nasal tip is a particular challenging aspect of rhinoplasty. We describe a surgical concept in nasal tip surgery that is novel in certain aspects. It combines maneuvers that are typically reserved for the open approach with the minimally invasive concept of endonasal rhinoplasty.
Methods:
Integral to the concept are the complete dissection and delivery of the lateral crus, repositioning of the dome, placement of alar strut grafts that extend far medially, and lateral advancement of the lateral crus.
Results:
This concept of nasal tip recontouring through the endonasal complete release approach is illustrated in detail. Representative cases are displayed, and outcomes in a population of 100 consecutive young female primary rhinoplasty patients are presented.
Conclusions:
The concept allows for excellent cosmetic and functional outcomes through a minimally invasive approach with preservation of a naturally soft nasal tip. Patient comfort is maximized by reduced swelling, avoidance of nasal packing, and obviation of external incisions.
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Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...