In short nose, the dorsal length is shorter than normal, the tip is upturned, and the nostril show is exaggerated. It can be congenital or more commonly, it is caused by complications of previous rhinoplasty. Repeated silicone insertion, infection, and traumatic manipulation of the tissue build up scar tissue around the tip which contracts and pulls the tip upwards. While overresection of cartilage is a common casue of this phenomenon in Caucasian rhinoplasty, implant related scar contraction is common cause in Asian rhinoplasty.
Correction needs a lot of work because the skin is contracted with decreased elasticity, the framework is damaged and weak, and often the inner mucosa is deficient. In severe cases, rib cartilage is a must material for grafting and wide skin undermining to move it downwards is necessary. Not infrequently, a staged operation is required. Deficiency inside the nose needs a composite graft from the ear. With all these efforts, the result is often not satisfactory. The key point for satisfactory result is lenthening the alar compartment with lengthening of the central tip compartment. When the tip and alar lobules are not in harmony, the result is unsatisfactory.
Correction needs a lot of work because the skin is contracted with decreased elasticity, the framework is damaged and weak, and often the inner mucosa is deficient. In severe cases, rib cartilage is a must material for grafting and wide skin undermining to move it downwards is necessary. Not infrequently, a staged operation is required. Deficiency inside the nose needs a composite graft from the ear. With all these efforts, the result is often not satisfactory. The key point for satisfactory result is lenthening the alar compartment with lengthening of the central tip compartment. When the tip and alar lobules are not in harmony, the result is unsatisfactory.
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