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Facial Plast Surg
DOI: 10.1055/a-2656-7021
Original Research

The Fusion Sling Hook Suspension as a Powerful Tool in Tip Support: Surgical Considerations

José Carlos Neves 
1   Department of Facial Plastic Surgery, MYFACE Clinic and Academy, Lisbon, Portugal
,
Jefferson Rijo-Cedeño
2   Department of Otolaryngology, Hospital Universitario La Moraleja, Madrid, Spain
,
Halana Filgueiras
1   Department of Facial Plastic Surgery, MYFACE Clinic and Academy, Lisbon, Portugal
,
Edgar Kaminskyi
3   Kaminskyi Clinic, Kyiv, Ukraine
4   Columbus Clinic Center and Ruesch Clinic, Milan and Naples, Italy
,
Fernando Nakamura
5   Perface Institute, Private Practice, Brasilia, Brazil
,
Froilan Paez
6   Servicio de cirugía Plástica Facial, Instituto de Otorrinolaringologia, Caracas, Venezuela
,
José Ramón García-Berrocal
7   Faculty of Medicine, University of S40 Paulo, Universidad Autonoma de Madrid, Madrid, Spain
8   Department of Otolaryngology, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
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Abstract

Introduction

Tip support in rhinoplasty is one of the main concerns during surgery. The reconstruction of the natural mechanisms of the tip for stabilization has become an increasingly fascinating and critical area of study.

Objectives & Hypotheses

This article evaluates the fusion sling hook suspension technique for tip support in rhinoplasties.

Study Design

Prospective observational case series.

Methods

A prospective analysis of 643 consecutive primary rhinoplasties performed between January 2020 and December 2024 was conducted, during which a careful dissection of the fusion sling anatomy was performed. Of these, 557 cases utilized the fusion sling hook suspension technique. Data were reported in accordance with the STROBE guidelines.

Results

The stability provided by the fusion sling hook maneuver proved to be highly effective and durable throughout the observation period. Seven patients (1.3%) who underwent the fusion sling hook suspension demonstrated some degree of loss of tip projection or rotation, among whom four (0.7%) required revision surgery.

Conclusion

The fusion sling flap offers stability, biomechanical logic, and anatomical continuity to the tip. Its strategic use can reduce the need for grafting or decrease the mechanical load placed on grafts, prevent late failures, and ultimately offer surgeons a more precise and versatile tool for long-lasting, natural tip projection.

Keywords

fusion sling - tip support - pitanguy flap - nasal tip - preservation rhinoplasty

Declaration of GenAI Use

Artificial intelligence-based tool, Chat GPT-4, was used solely to assist with English language editing and did not contribute to the conceptual or substantive content of the article.




Publikationsverlauf

Accepted Manuscript online:
16. Juli 2025

Artikel online veröffentlicht:
07. August 2025

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