Nasal Tip Aesthetic (Tipplasty)

In brief, the asthetic nasal shaping procedures without touching/operating nasal bones are called nasal tip aesthetic (tipplasty). The nasal tip area consists of septum, which I call it “wheel cartilage”, and the wing cartilages on the nasal roof. The parts of the structures that these cartilages form into the nose in three-dimensions are called Nostril, and the tissue between the two nostrils is called columella. In the medical literature, the end part of an organ is called “tip”, we call nasal tip surgeries “Tipplasty”.

Tipplasty is generally the correction procedures of asymmetries of nasal tip, rough, wide, flat and ptosis nasal tip. The surgeries performed for aesthetic shaping of this area again are called “Tip Revision”  The diameter and shape of the nostrils together with 3D angle of the wing cartilages with septum determine the breathing functions and quality of the nose. This important role of the nasal tip, both functionally and aesthetically, determines how the nose and face is perceived together. The aesthetic problems of the nasal tip may be congenital and postoperative, and may develop due to accidents or burns.

The tipplasty (surgical solutions of problems of nasal aesthetic) can be performed under local anesthesia or sedation, and general anesthesia for the comfort of the patient. All of the tipplasty procedures are performed by considering the relationship of cartilages, wings and soft tissues between each other. In brief, the excess and drooping areas are not corrected/fixed by simply cutting. The approach in this respect should be the domino effect, not like the toy block.

Stitches, patches and supportive materials appropriate for the problem of the patient can be used in order to make the outcome permanent and predictable by planning the shapes of bonded and adherent tissues following the surgical procedure. If the procedure risk is little, and the outcome is not important, different thread materials, filling materials and neurotoxins can also be used in order to give shape to this region within tipplasty. These last procedures may not be required to be a plastic surgeon or even a surgeon or may not require anesthesia or even a hospital. Many procedures performed within non-operative tipplasty procedures are supportive retouching procedures. Rather than the side effects of these procedures with low impact profile, the most important features of these procedures are that they are temporary and need to reoperation.

In this reading/text, I introduce surgical tipplasty procedures.

Holistic approach principles

The aesthetic problems of the nasal tip cannot be evaluated only with nasal tip or together with nose alone. The nose is an organ that complements the face, and the nasal tip is an essential and central part of the nose. In all holistic evaluations, there is no other organ that plays the dominant role in the image of the face except for nose. Our image is formed by the relationships, structures and ratios of the organs of the face, both between themselves and each other. This ratio and harmony are unique and special. The nose represents itself as much as the length of the nasal tip, by taking place in the center of the face. The problem is not limited to the nasal tip for person who has nasal tip problem, the problem affects/influences all of the nose, then face and image, and even psychological health. The skin is the largest organ of our face, and the nose is the most important and attractive organ of the face, the nasal tip is the most important part of the face. Within logic sequence and holistic (Gestalt) perceptual principles, as we have understood how nasal tip is related to image and psychology of the person, we not pass on to what can be done with the medical examination/procedures.

Technique

Reducing the wing width of the nasal wings which are wide, flat and low for the facial image, is the most commonly performed tipplasty procedures. This procedure also provides shaping to nose/lip, nose/cheek angle, the height of the nose together with nostrils. The procedure is completed under local anesthesia and in approximately 25-30 after marking.

Drooping nasal tip is one of the most common aesthetic problems of tipplasty. It is possible to reduce, lift, and shape the nasal tip cartilages which the enlargement/growth does not stop over time (ear cartilages also grow over time) in accordance with the holistic principles at the earliest time. The surgery performed for this purpose is necessary to be performed only in the operating room as it requires intervention to the septum.

The location of the nasal tip (behind or in front) the roughness, asymmetry and excess parts caused by excessive cartilage continued with back of the nose are considered among the aesthetic problems in tipplasty. Following the 3D geometric aesthetic, functional and proportional relationship of the nasal tip, the structures such as lips, jaw tip and cheekbones may be required medical interventions simultaneously

Tipplasty

One of the most important variables related to tipplasty is skin and bone skeleton structure disorders. Surgical planning should be done by analyzing these parameters which are directly related to the tipplasty. The congenital anomalies such as flattening of the upper jaw which is called maxilla (hypoplasia), upper teeth alignment disorders, cleft lip and palate cause the asymmetric appearance in the bone structures of that area.  The firming and thinner procedures can be recommended for nasal skin in people with heavy, oily/fat and thick nasal skin. Among these procedures, skin firming and rejuvenation techniques such as multi-sessional Fractional Radiofrequency procedures can be used, as well as fat-burning drugs.

Tip revision surgeries are secondary correction procedures of the nasal tip with a careful evaluation, planning and surgery, which is not frequently encountered. If necessary, the filling materials can be used to correct skin irregularities and volume loses. It is necessary to carefully evaluate and research the nasal tip lifting procedures which are unpredictable/unforeseen and varying from person to person, and have performed with thread that has many side effects, within medical aesthetic procedures rather than plastic surgery. Because, how the nasal tip affects our life in the multi-level perceptual, holistic and physical life is detailed above.