Cephalic Rotation of the Nasal Tip

The position of the nasal tip holds important aesthetic significance. Cephalic rotation of the nasal tip is a frequent motivating factor for patients seeking rhinoplasty. The position of the nasal tip is a complex interplay of the size, morphology, and position of several anatomic components of the lower one-third of the nose. Cephalic rotation can be achieved by way of six different methods. The indirect methods promote passive cephalic rotation and include cephalic trim of the lower lateral cartilages, caudal trim of the upper lateral cartilages, and caudal septal trim. Direct methods involve precise repositioning of the domes and include shortening the lateral crura, lateral domal relocation, and the tip rotation suture. Used alone or in combination, these techniques and their subtle variations, represent comprehensive and effective methods to achieve cephalic rotation of the nasal tip. Disclosure: Dr. Rohrich is a volunteer member of the Allergan Alliance for the Future of Aesthetics and receives instrument royalties from Eriem Surgical, Inc., and book royalties from Taylor and Francis Publishing. No funding was received for this article. Corresponding Author: Paul N. Afrooz, MD, Institute of Aesthetic Medicine, 3225 Aviation Avenue, Suite 100, Coconut Grove, FL 33133, Paul.Afrooz@gmail.com ©2018American Society of Plastic Surgeons

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