A technical refiniment to prevent supratip deformity in aesthetic rhinoplasty:"the trapezoid peak"

Background: The relationship between appropriate caudal dorsum resection and supratip deformity or inadequate tip projection currently is clear. Correct quadrangular cartilage management seems to have a basic role in the final tip aspect after aesthetic rhinoplasty. Methods: Primary aesthetic rhinoplasty was performed for 38 Caucasian patients. A septal refinement was used for patients requiring extra tip support and not requiring grafts. Results: The minimum follow-up period was 1 year. No supratip deformity was noted after surgery. The tip and midvault had adequate projection. Conclusions: The described maneuver sustains the alar cartilage without sutures, preventing supratip deformity, sustaining soft tissues, and avoiding loss of tip projection.