Rethinking the logic and techniques of primary tip rhinoplasty: A perspective of the evolution of surgery of the nasal Tip.

Historically, destructive tip-shaping and positioning techniques, although effective to some degree, have created large numbers of secondary deformities. Tip grafts, necessary in secondary rhinoplasty, have been applied widely in primary rhinoplasty. Their use has introduced variables and has led to a significant reoperation rate. Nondestructive tip-shaping and positioning techniques offer the surgeon a wider range of alternatives, more control and predictability, and a reduced reoperation rate.