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Nasal tip deprojection with crural cartilage overlap: the M-arch model
Noah Benjamin Sands1, Peter A Adamson1
1Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto General Hospital, R. Fraser Elliott Building, 190 Elizabeth Street, Room 3S - 438, Toronto, Ontario M5G 2C4, Canada; Adamson Associates Cosmetic Facial Surgery, 150 Bloor Street West, M110, Toronto, Ontario M5S 2X9, Canada.
Abstract:
Vertical arch division is a mainstay of tip surgery, and its applications are expanding. It allows deprojection of the overprojected tip, and modifies rotation, length, and lobule definition. These parameters can be altered in a controlled, predictable fashion when the alar cartilage is preserved and overlapped, maintaining its strength. Cartilage overlay techniques aim to preserve normal anatomy and establish support for the nasal framework. We discuss the uses of vertical arch division when applied to the M-arch model, an expansion of the nasal tip tripod concept, which provides for a utilitarian approach to surgical techniques for the nasal tip.
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