Tip Plasty: A New Modified Vertical Dome Division. “How I Do It?”

This manuscript aimed to report a new vertical dome division technique for the correction of different common nasal tip deformities. This technique is a novel approach and was never reported in the literature to the best of our knowledge. The technique was performed using an open approach on 337 patients presenting with a combination of different nasal tip deformities: overprojected nasal tips, drooping tips, asymmetical tips and wide domal arches. The included patients were operated on between 2012 and 2018, with a follow-up period of at least 1 year. A detailed description of the surgical steps used is provided. Surgery outcomes were predominately positive, with unsatisfactory results obtained only in 11 of the 212 included patients (125 patients were excluded from the study due to inadequate or no follow-up). Satisfactory results and minor complications were detected following this procedure. In conclusion the presented technique is an easy and effective method for the narrowing, uprotation, and deprojection of nasal tips as well as the correction of tip asymmetries mainly in thick-skin patients, with a low complication rate.