This video demonstrates nasal tip deprojection utilizing the nasal tripod concept. A 2 millimeter shortening is planned whereby a 1 millimeter amount of shortening may not be enough and 3 millimeters, which may be indicated in certain patients, is a larger movement. In 1969, Dr. Jack Anderson described the tripod concept. This landmark paper has served to help rhinoplasty surgeons understand nasal tip dynamics and in turn allow surgical planning. This representation utilizes both lateral crua and the paired medial crua as a tripod. In this case of a patient who wished to have nasal tip deprojection, this concept is utilized by shortening of the medial crua by 2 millimeters. And in this setting, an overlap of the medial crua is performed and suited into place. It is important to illustrate to patients what happens to the nasal skin and nostril shape with a deprojection of the nasal tip or a shortening of the medial tripod of the nose. The anterior nares are similar, however the nares change shape with deprojection even though the area roughly stays the same. And in this setting, monofilament sutures are utilized to carefully overlap the cartilage by the measured amount. Both paired medial crua are placed within the columnar base, remaining cartilages and sutured into place. This shows the completed construct on one side.

nasal tip deprojection

nasal tripod concept

medial crua shortening

rhinoplasty technique

Dr. Jack Anderson