A Technical refinement to prevent supratip deformity in aesthetic rhinoplasty: "the trapezoid peak"

BACKGROUND. The relationship between appropriate caudal dorsum resection and supratip deformity or inadequate tip projection currently is clear. Correct quadrangular cartilage management seems to have a basic role in the final tip aspect after aesthetic rhinoplasty. METHODS. Primary aesthetic rhinoplasty was performed for 38 Caucasian patients. A septal refinement was used for patients requiring extra tip support and not requiring grafts. RESULTS. The minimum follow-up period was 1 year. No supratip deformity was noted after surgery. The tip and midvault had adequate projection. CONCLUSIONS. The described maneuver sustains the alar cartilage without sutures, preventing supratip deformity, sustaining soft tissues, and avoiding loss of tip projection