The nasal tip is a complex structure which requires meticulous analysis before deciding on surgical technique. Analysis includes: tip projection, tip rotation, definition and symmetry.
The nasal tip can be increased or decreased with sutures or grafts. The tip rotation can be increased or decreased by removing cartilage (cephalic trim) or adding cartilage. Tip definition is either boxy, bulbous or normal and usually tip-defining sutures can be used to contour the tip.
Tip definition can be improved by removing fatty tissue or scar tissue and contouring the cartilages. Any analysis requires an in-person evaluation with a board-certified plastic surgeon with experience in rhinoplasty.