The Plunging Tip: Analysis and Surgical Treatment
Open Access
- 21 April 2015
- journal article
- Published by Oxford University Press (OUP) in Aesthetic Surgery Journal
- Vol. 35 (4), 367-377
- https://doi.org/10.1093/asj/sju110
Abstract
BackgroundThe plunging tip refers to a deformity in which the nasal tip plunges on smiling.ObjectivesTo understand the plunging tip, we have updated our series of 25 cosmetic rhinoplasty patients who complained of a plunging tip with a focus on the anatomic changes of the nose on smiling.MethodsTwenty-five female cosmetic primary rhinoplasty patients who complained of a nasal tip that plunged on smiling were photographed in static and smiling sequences preoperatively and one year postoperatively. Different nasal angles and landmarks were measured to study changes of the nose.ResultsPre- and postoperatively, there was no statistically significant difference in the changes in the nasal angles and landmarks on smiling. At one year postoperatively, 2 patients had nasal tips that continued to plunge on smiling; these patients had requested no increase in tip rotation preoperatively. Only 2 patients had columellar base muscles cut for reasons other than treating the plunging tip.ConclusionsThis is the first prospective, evidence-based study on the plunging tip. Measurements of the nose before and after surgery demonstrate that the nasal tip moves less than 1 mm and 1 degree on smiling. Treatment of the plunging tip illusion was effective by increasing the tip angle in repose. No columellar base muscles were cut to treat the plunging tip, and the nose moved just as much after surgery as before. Cutting or manipulating muscles is not necessary for treatment. To treat the illusion, the surgeon must increase tip rotation.Level of Evidence2 TherapeuticKeywords
This publication has 10 references indexed in Scilit:
- Smile Analysis in RhinoplastyPlastic and Reconstructive Surgery, 2014
- The Plunging TipAesthetic Surgery Journal, 2014
- Defining the Ideal Nasolabial AnglePlastic and Reconstructive Surgery, 2012
- Mastering RhinoplastyPublished by Springer Science and Business Media LLC ,2010
- Rhinoplasty with Advancing AgePlastic and Reconstructive Surgery, 2004
- RhinoplastyPublished by Springer Science and Business Media LLC ,2002
- Dynamic Rhinoplasty for the Plunging Nasal Tip: Functional Unity of the Inferior Third of the NosePlastic and Reconstructive Surgery, 2000
- RhinoplastyPlastic and Reconstructive Surgery, 1993
- Surgical lengthening of the short columella: division of the depressor septi musclesEuropean Archives of Oto-Rhino-Laryngology, 1992
- Symposium: The Supra‐tip in rhinoplasty: A dilemma: II. Influence of surrounding structure and preventionThe Laryngoscope, 1976