Reducing the risk of cartilaginous supratip deformities.

One of the most dramatic results of aesthetic rhinoplastic surgery is that of a pleasing profile. Tip position, a barometer of the acceptable profile, is important to obtain a successful result. However, because of local anesthetic and surgical edema, realization of the final tip position in relation to the supratip dorsum can be deceiving. Postoperative tip drop must be considered when the final intraoperative result is reached. Gender of the patient plays a large part in the tip position desired. Males tend to prefer straighter dorsal profiles. Females often desire a greater difference between the tip and dorsum. Achieving these results can be difficult; therefore, the purpose of this discussion is to quantify, numerically, the difference between immediate postoperative results and one-year results. To quantify these differences, intraoperative measurements of the tip/supratip difference were made in 23 patients. These measurements were then compared with the one-year postoperative results. For female patients, the results indicate a 4 mm to 7 mm intraoperative difference to achieve a 0 mm to 2 mm postoperative difference. In males, the immediate postoperative measurement should be 3 mm to 4 mm in order to obtain a result of 0 mm to 1 mm, the ideal for a male.