摘要

Objectives: Rhinoplasty in thick skin patients could be very challenging. Difficult skin re draping, lax and weak ligaments, thin and flimsy cartilage all are contributing factors to failure of distinction between the different subunits of the nose. Introduction: Most of the soft tissue relationships and many of the structural components contributing to the support of the nasal tip are disrupted during an open approach specially Pitanguy and scroll ligaments. Also, the strength of weak cartilage in thick skin nose becomes more week by surgical manipulation. Aim of this study is to asses the long term outcomes of rhinoplasty with both tip structure and ligaments preservation. Materials / method: 43 patients underwent open rhinoplasty with ligaments preservation and tip structure technique considering nasal base stabilization with septal extension graft and other tip grafts. Results: All patients have better aesthetic and functional outcome with long lasting definition, projection and rotation. Conclusion: refinements of nasal surgery have no limits. Study suggests that structural nasal tip with ligaments preservation could maintain nasal tip definition, projection, and rotation.