ABSTRACT
Reliable outcomes in correction of the severely bulbous nasal tip remain elusive.
Reduction and binding of the tip cartilages result in a partial external nasal valve
collapse. If a concurrent dorsal hump reduction is accomplished and osteotomies are
completed to close the open roof deformity, then a severe constriction of the external
valve may result. This is best avoided by resection of the residual lower lateral
cartilages and substitution with external valve batten implants. The tripod of nasal
tip supports is then rigidly reconstituted. When autogenous graft materials are considered
inadequate or undesirable, the surgeon may safely use porous polyethylene alloimplants
to support the external nasal valve. A dependable surgical technique based on extensive
experience with these materials is outlined.
KEYWORDS
Rhinoplasty - severe bulbous tip - alloimplants - porous polyethylene