Abstract
Aesthetic improvement of the ptotic, bulbous nasal tip requires maneuvers that will increase tip projection and improve tip definition. Tip projection can be increased by using dome division with suturing of the medial crura. Precise pockets can be used for soft-tissue excision and placement of onlay grafts. Onlay tip grafts can increase tip projection as well as provide tip definition. Successful use of onlay tip grafts requires precise pocket placement with carefully shaped grafts that fit snugly into the pockets. In this article, incisions used to approach the nose, dome division techniques and onlay grafting are covered.
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