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This ethnic Asian rhinoplasty case of Filipino origin was featured by the typical anatomical peculiarities of Far Eastern ethnicities, including a very short nasal length, a very short and flattened tip which also was underprojected, null tip definition and a very low dorsum, finally the nose was upturned and the tip too high or piggy.

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Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 1
#1The lateral cruras of the lower lateral cartilages are massively covered by a thick layer of fibrofatty tissue, a very common finding in Asian noses.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 2
#2Note how bulky is the adiposity and its unsightly effect on the lower third of the nose; the tip is nonexistent, literally, the domes of the tip are not developed in Asian noses.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 3
#3After meticulous and careful debridement all the fibrofatty layer has been removed, to slim down the nose and make it more defined; the circle spots the area were the tip domes should be present; nothing exists there instead, the tip needs to ...Read more
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 4
#4The circle spots is where the tip angle and the domes of the lower lateral cartilages should be present; note how thin and filmy are the lateral cruras, the medial cruras are barely detectable.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 5
#5The forceps grasps the inner mucosa lining to tighten the right lateral crura, this shows how extremely thin and weak they are; where is the tip? And the medial cruras? Never were developed.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 6
#6The forceps grasps mucosa to tighten and show the left lateral crura thin and filmy structure; arrows point to both lateral cruras and the circle spots the stumps of the remains of the medial cruras, which in practical terms are congenitally ...Read more
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 7
#7The circle spots where theoretically should be the left medial crura and tip dome, nothing exists there instead but a mere fibrotic cord without any supportive role.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 8
#8See the very short septum and its 45 degrees angle from the horizontal plane; this is one of the main causes of nasal shortness and lack of tip support.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 9
#945 degrees from the horizontal plane; ideally should be between 0 and 20 degrees, depending the anatomy and the aesthetic racial canons.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 10
#10See the gap between the columella and the caudal or lower end of the septum, this space is the actual lengthening requirement.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 11
#11Close up view of the septal shortage.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 12
#12One on one septal lengthening, the key reconstructive pillar in this case; see how the caudal missing gap of septum was restored using deep septum cartilage grafting; the vertical arrow shows the juncture point; note how the columella is significantly ...Read more
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 13
#13Columella pushed down by the caudal septal extension graft; the original 45 degrees angle and the new 0 degrees angle of the caudal septum.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 14
#14Original septum and the one on one septal lengthening graft, a very delicate high end maneuver; note the new horizontal columella compared with the previous upturned angle one.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 15
#15Perfectly customized caudal septal extension graft; it has a triangular shape due to the peculiarities of this case.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 16
#16The septal lengthening graft has to be think and strong enough to support the entire nose and push down the columella.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 17
#17Close up detail of the sutured septal extension graft.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 18
#18The right ear donor site; the posterior access allows a hidden scar behind the auricle; the crus of the helix is essential for the ear support and has to be preserved; the areas that can be safely harvested are the upper concha fossa or cymba ...Read more
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 19
#19The cartilage portions harvested are shown in correspondence with the anatomical creases and fossae were they do belong to; the helix crus is firmly supporting the ear as a beam.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 20
#20Concha's cymba graft.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 21
#21Concha's cavum graft.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 22
#22Note how the helix and antihelix creases are not deformed or distorted if the surgeon is proficient harvesting the grafts.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 23
#23Rear view of the left ear donor frames of cartilage; harvesting cartilage from the ear is not a trivial or simple maneuver at all.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 24
#24Left ear anterior vision showing the harvested cymba y cavum fossae; now the surgeon has to close the donor sites and carry out the customization, tailoring and shaping of the new structural elements to fit in the newly planned nasal shape.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 25
#25Concha's cymba graft.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 26
#26Concha's cavum graft.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 27
#27Left ear's anterior view showing no anatomical deformity or distortions.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 28
#28Seventh rib access to its cartilage once the perichondrium ha been lifted off the rib cartilage; the arrows point the first cuts made at the outer cortex.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 29
#29Reference view of the inframammary access to rib cartilage harvesting.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 30
#30The outer cortex of the seventh rib cartilage fully separated from the core cartilage shaft.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 31
#31This portion grasped by the forceps must be discarded; it belongs to the outer layers and they are featured by warping.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 32
#32As soon as it is separated the outer layers warping effect is immediate and evident; the arrows point to the core shaft or central rib cartilage which is the safe and optimal donor area to be use in rhinoplasties.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 33
#33Deep surface of the warping outer layers of rib cartilage; this has to be discarded.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 34
#34The core cartilage of the rib has been extracted, tailored and shaped as nasal dorsum graft; here there is a comparison between the warped outer layers and the central shaft which stands firmly straight.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 35
#35The straight graft is precious and form stable, it belongs to the central portion of the rib shaft; the warped item should not be used unless a curvaceous effect is sought.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 36
#36The nonexistent medial cruras were replaced by the grafts pointed by the arrows, fixed to the new caudal septum in a tongue in groove maneuver.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 37
#37The new columella will be lower and horizontal.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 38
#38The new medial cruras, made from ear cartilage.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 39
#39Note the massive advancement achieved, the forceps pull down the lateral cruras and they are not long enough to meet the new nasal angle; see the gap pointed by the arrow at the lower lateral or triangular cartilages, once the nose is lengthened ...Read more
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 40
#40The original lateral cruras are so short that they can't reach to the new nasal length; the triangular cartilages need lengthening to fill the gap at the nasal wall.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 41
#41The original lateral cruras were re used as triangular cartilages caudal extension graft; the lateral cruras were rebuild using hand made ear cartilage pieces; T for triangular cartilage, NT for new triangular cartilage, NC for new lateral crura, ...Read more
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 42
#42Comprehensive view of the new nasal structure, massively lengthened.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 43
#43D for dorsum, T for triangular cartilage, NT for new triangular cartilage, NC for new lateral crura, NS for new caudal septum.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 44
#44New left lateral crura and nasal wall.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 45
#45New left right lateral crura and nasal wall.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 46
#46NC for new lateral and medial cruras; NS for new caudal septum in between the new medial cruras in a tongue in groove structure.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 47
#47Lower third of the nose fully resupported.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 48
#48Onlay columella graft to rebuild it, ear harvested.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 49
#49Lateral view of the new tip support tripod, with the onlay columella graft applied and secured by sutures.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 50
#50Hand made and customized new tip made with a shield tip graft from ear cartilage, located at the new nasal angle and secured in place by sutures.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 51
#51Note how a grid of scoring was made unicortically to achieve a softer and more elegant effect of curvature at the tip.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 52
#52Lateral view of the final assemble with the tip graft applied and secured by sutures.
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 53
#53The core rib cartilage fully shaped, tailored and thoroughly tested to fit into the dorsum as onlay graft to raise its level; note how the upper and lower ends are beveled and made, respectively, round and triangular to mimic the natural shape ...Read more
Alar rim retraction,Angled dorsum,Asian nose,Broad nose,Bulbous tip,Dynamic alar flaring,Flat dorsum,Humpless dorsum,Low dorsum,Low radix,Parenthesis tip deformity,Poorly defined tip,Poorly supported tip,Rounded tip,Saddle nose deformity,Short nose,Short septum,Short upper lateral cartilages,Small alar cartilages,Small nose,Sunken supratip,Thick skin nose,Underprojected tip,Columella lengthening,Columella strut graft,Custom made tip graft,Dorsum replacement graft,Ear cartilage graft harvesting,Extended columella strut graft,Intercrural columella plasty sutures,Interdomal tip plasty sutures,Lateral cruras caudal extension graft,Lateral cruras custom made graft,Lateral cruras lengthening graft,Lateral cruras replacement graft,Lateral cruras repositioning,Medial cruras custom made graft,Medial cruras lengthening graft,Medial cruras replacement graft,Onlay columella graft,Onlay dorsum graft,Onlay radix graft,Onlay supratip graft,Onlay tip graft,Open approach incision,Rib cartilage graft harvesting,Septal cartilage graft harvesting,Septum caudal extension graft,Shield tip graft,Tip defatting,Tip replacement graft,Tongue in groove columella setback,Transdomal tip plasty scoring,Triangular cartilages caudal extension graft - photo 54
#54Lateral view of the dorsal raise onlay grafting allowing vision of the tricky tailoring of its upper and lower ends.

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