Correction of the plunging nasal tip: 7CASES.

Yoon, Chang Shin; Oh, Kap Sung

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 1998;25(8):1552-1559.
Published online December 1, 1998.

Correction of the plunging nasal tip: 7CASES.

Chang Shin Yoon, Kap Sung Oh

Abstract

The primary factors determining nasal tip outline are shape and position of the alar cartilages. The relation of the alar cartilages to the upper lateral cartilages, septum, and soft tissue envelope defines the conformation of the tip-lobule complex. Plunging tip is a condition as long nose, tip drooping and becomes more accentuated with aging. Hanging columella is a prominent downward bowing of the columella. Plunging tip and hanging columella are common causes of acute nasolabial angle.Correction of the plunging tip in the long nose is usually achieved satisfactorily through shortening of the lateral walls by excising an adequate amount of cartilage from the septal, lateral, and alar cartilage. Tip rotation in a cephalic direction can be achieved commonly by resection of the cephalic portion of the lateral crura, excision of a triangular segment of the caudal margin of the septum and a cartilaginous septal transfixion incision involving excision of a superiorly based triangle of septum with cephalic rotation of the entire nasal lobule.Modification of the caudal margin of the septum is done to achieve three goals: (1) cephalic rotation of the tip, (2) shortening of nasal length, and (3) alterations in the nasolabial angle. We have elevated and rotated in a cephalic direction nasal tip by means of resection of cephalic portion of lateral crura, resection of the caudal margin of the septum and mucous membrane, and /or invagination technique for correction of the plunging tip and hanging columella. From March 1996 to February 1998, we have performed the tip-plasty in 7 patients of the plunging tip and hanging columella. We have found good cosmetic results with improved nasolabial angle.

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