This paper shows an original and effective procedure for total nasal tip framework reconstruction using autologous auricular cartilage. The authors explain how the seagull-wings technique, described some years ago by one of them (Fernando Pedroza) to treat severe nasal tip deformities due to overresection of lower lateral cartilages, did not achieve a satisfactory result in some issues like columellar retraction. This new technique solves the problem in an elegant way by adding an extended shield graft to the seagull-wings graft in order to increase tip projection and columellar exposure. Statistical analysis performed on this 64 patient group showed consistent improvement in every parameter of the study, reaching strong significance in tip rotation, projection, definition, alar pinching or columellar retraction. The methodology is adequate and the images of the technique and the one-year results are excellent. This paper is very interesting for rhinoplasty surgeons, since it explains clearly a useful technique to deal with secondary tip deformities, one of the most challenging situations in facial plastic surgery. Fernando Pedroza is a world-known master in nose surgery and has one of the largest experiences in revision rhinoplasty; every article authored by him should be read by any nose surgeon around the world.

The tripod graft. Nasal tip cartilage reconstruction during revision rhinoplasty.
Pedroza F, Pedroza LF, Achiques MT.
2014; Epub ahead of print.
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Eduardo Morera Serna

Hospital Universitario Son Espases, Palma de Mallorca, Spain.

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