Controlled tip sculpturing with the morselizer.

Modification and refinement of the nasal tip has long been regarded as the most difficult and complicated procedure in rhinoplasty. The various procedures and approaches to this surgery have been characterized by removal of increasing amounts of lateral crus in an effort to develop greater definition of the tip. This has resulted in a number of iatrogenic deformities. In addition, it has resulted in undesirable and uncontrolled amounts of rotation and retrodisplacement. A technique with some variations that I have used for a number of years serves to overcome most of these problems while providing excellent definition to the tip. This method, with some variations, leaves 90% to 100% of the lower lateral cartilages of the nose that serves as a lateral strut. This limits the retrodisplacement and rotation that takes place when scar tissue replaces the excised lower lateral cartilages of the nose.