Complications Found in Asian Tip Surgery
06 May 2012 (online)
Controlling the nasal tip in terms of definition, projection, and rotation requires a firm platform for subsequent scar contracture, healing, and skin thinning. Complications from tip surgery are diverse and range from symmetry, unnatural appearance, graft problems (migration, infection, extrusion), and issues with function. Implants are a large part of untoward results at the tip, and this article will focus on common complications that arise. In general, substantial projection should be pursued with a caudal extension graft rather than simple columellar strut. Compressive forces at the tip are formidable and the caudal septum, or simpler suture techniques, will often not hold up. Cap grafts and tip grafts that are used for projection or definition must be carefully camouflaged, irrespective of the thickness of the overlying skin. Even ethnic patients with thick skin will often reveal the edges of their grafts after several years. Alloplastic implants can be used but only after careful deliberation of risks and alternatives.