A Graduated Method of Tip Graft Fixation in Rhinoplasty

Abstract

At the fall meeting of the American Academy of Facial Plastic and Reconstructive Surgery, Ira D. Papel, MD, Baltimore, Md, presented the above-mentioned paper. Dr Papel noted that tip projection has gained increased recognition as an integral factor in successful aesthetic and reconstructive rhinoplasty, and tip cartilage grafting has become one of the major methods of obtaining increased tip projection. Earlier techniques of tip grafting relied only on pocket fixation, while the population of open rhinoplasty has revealed the stability and ease of direct suture fixation of tip grafts to the nasal framework. Recognizing that not all rhinoplasties will require an open technique, the author has sought to classify and categorize the deficiency of tip projection and develop indications for specific tip-grafting techniques based on this classification. Dr Papel's study involved 309 rhinoplasties performed from 1989 through 1992. All patients underwent initial consultation, photography, and/or computer imaging. Nasal-tip projection ratio