Addressing the complexity of nasal tip contouring

Reviewed by James Ives, M.Psych. (Editor)Feb 11 2020

The dramatic shift in how nasal tip surgery is being performed given changes in the intended goals and evolving techniques is highlighted in a Special Communication by and interview with Dean Toriumi, MD, published in the Official Journal of the American Academy of Facial Plastic and Reconstructive Surgery, Facial Plastic Surgery & Aesthetic Medicine, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. Both the Special Communication and the Interview can be viewed free on the Facial Plastic Surgery and Aesthetic Medicine website through March 10, 2020.

In the Special Communication titled "Nasal Tip Contouring: Anatomic Basis for Management," Dr. Toriumi addresses the complexity of nasal tip contouring and helps rhinoplasty surgeons navigate the many techniques available to them. He discusses the ideal nasal tip contour, options for stabilizing the base of the nose, techniques for reorienting existing tip structures, and shield tip grafting. He also recommends learning as much as possible from each case by following previous patients.

In an interview with Dr. Toriumi, led by journal Editor-in-Chief, Dr. John Rhee and titled "Evolution of a Rhinoplasty Master," Dr. Toriumi highlights a key theme over the past 30 years: the use of structural grafting to make the nose stronger and provide a better long-term aesthetic and functional outcome. Dr. Toriumi points out that structure rhinoplasty is neither preservation rhinoplasty nor is it destructive. Instead, the existing structures are supported by adding cartilage grafts. In describing the evolution in tip grafting, he says that shield tip graft can be very useful if used properly. Dr. Toriumi also discusses complex techniques at high execution risk that should be performed by more experienced surgeons. The interview also focuses on future trends in the field.

Dr. Toriumi has been a generational thought leader in rhinoplasty. This is yet another blockbuster article that takes us along on his personal decades-long journey and evolution in addressing the nasal tip."

John S. Rhee, MD, MPH, Medical College of Wisconsin, Milwaukee, Facial Plastic Surgery & Aesthetic Medicine Editor-in-Chief