Boxy tip deformity

1. Boxy tip deformity Babak Saedi Assistant professor of Tehran university Imam Khomainey hospital

3. Definition • The boxy tip is defined as a broad , rectangular tip as seen on basal view

5. Rhodrich & Adams :Three types

6. Traditional approach • Goldman Dome resection to reshaping of nasal tip • Sheen Cartilage scoring Weakness Notched alar rim, pinched tip ,asymmetry , decrease tip projection

7. Constantian, Mark B in 200 boxy tip emphasis in lateral crura weakness and malposition • Tebbetts, non destructive technique in all form of boxy tip deformity

8. Preferred technique • Cephalic trim Resection of lateral crura adding to medial portion of medial crura Cartilage suturing

9. Final goal The operative goal : • reposition the tip definition points • Angulate the domes • Shape lateral crura

11. Type I & III

12. Type II

13. Type I & III

14. Type II

15. Type III and thick skin

17. Thank you