The plunging tip: analysis and surgical treatment

Area of Science:

• Plastic Surgery
• Facial Anatomy
• Rhinoplasty Techniques

Background:

• The plunging tip is a nasal deformity where the tip drops during smiling.
• This study investigates the anatomical changes associated with this condition.

Purpose of the Study:

• To understand the plunging tip deformity in cosmetic rhinoplasty.
• To analyze the anatomical changes of the nose during smiling in patients with this complaint.

Main Methods:

• Prospective study of 25 female rhinoplasty patients with a plunging tip.
• Preoperative and 1-year postoperative photographic analysis of nasal angles and landmarks during smiling.
• Measurement of specific nasal angles and landmarks.

Main Results:

• No statistically significant difference in nasal angle/landmark changes on smiling pre- and post-surgery.
• Two patients still experienced a plunging tip postoperatively; they had not requested increased tip rotation.
• Columellar base muscles were rarely cut for reasons other than treating the plunging tip.

Conclusions:

• Increasing the tip angle in repose effectively treats the plunging tip illusion.
• Nasal tip movement during smiling is minimal (less than 1 mm and 1 degree).
• Surgical correction does not necessitate cutting or manipulating columellar base muscles; increased tip rotation is key.