Tip refinement – Advanced Rhinoplasty Meeting, Chicago, May 2013

I was very pleased that my ideas on tip refinement that I presented last week in Chicago were well received by expert surgeons I respect.

My goal is a natural, non-surgical tip.  I try to create normal from abnormal anatomy.  I try to reshape without removing tissue, as this provides longer-term stability.  This is mainly achieved with stitches/sutures and grafts.  Each technique we use has the possibility for producing changes that we don’t want in one direction whilst achieving what we do want in another, and I highlighted the importance of watching very carefully during surgery the 3D effects of our manoeuvres. A significant part of the mix of art and science in tip surgery is to not just create the effects that we do want but to counteract the effects that we don’t want again with small slivers of cartilage and small, carefully positioned stitches.

To get an idea of our treatments, watch our page “Understanding the operation”.