[Correction of the sloping nasal tip. Comparison of various surgical methods]

In the correction of nasal-tip ptosis, cephalic rotation of the nasal-tip complex is necessary. Various methods are retrospectively compared, including operative approaches, modifications of the lower lateral cartilages, and adjunctive tip rotation techniques. Pre- and postoperative profile photographs of 50 patients with tip ptosis are examined, the changes of the nasolabial angles measured, and analyses of the operative techniques performed. A maximum of cephalic rotation is seen after techniques with interrupted alar cartilage strips. Adjunctive techniques such as upper lateral cartilage shortening, intercartilaginous sutures, and cartilage grafts can increase the rotation effect. More cephalic rotation seems to happen after delivery than after retrograde-eversion approaches if no additional rotation techniques are utilized besides cephalic shortening of the lower lateral cartilages. Last but not least, several individual factors have to be considered that play a critical role in tip rotation such as the dynamics in healing and contracture ability of the overlying skin. With these results in mind, a stepwise approach to the correction of nasal tip ptosis is recommended.