Narrowing of the wide nasal tip

The causes of wide nasal tips include: 1) bulbous lateral crura; 2) wide arching between the medial and lateral crura; 3) thick skin; and 4) wide interdomal distance. In primary rhinoplasty, most tip width is found to be caused by the bulbous lateral crura and wide arching between the lateral crura of the lower lateral cartilages. In some patients the interdomal distance must be narrowed to give the esthetic desired result. An interdomal distance greater than 3 mm should be corrected. The technique of unilateral partial delivery of the right crus up to and including the dome, with removal of the soft tissue between the separated medial crura, is described as an efficient way of narrowing the interdomal distance. This technique was required in 5% of the cases.