The Effectiveness of Modified Vertical DomeDivision Technique in Reducing Nasal TipProjection in Rhinoplasty

Background: the technique of vertical dome division or tipdefining, involves incising the lateral crura and vestibular skinat or lateral to the dome or tip defining point. the incision dividesthe lower lateral cartilage into a lateral segment and a medialsegment, which are advanced anteriorly and sutured togetherto increase tip projection. the present study aimed at assessinga new vertical dome division, which is a modified versionof vertical dome technique to decrease nasal tip projection, andincrease or decrease nasal tip rotation and other tip deformities.methods: the medical files of patients undergone rhinoplastyfrom 2003 to 2008 were retrospectively analyzed. the files wereselected from a computerized rhinoplasty database of patients,who had been operated using a modified vertical dome techniqueand followed-up for one year or more after the surgery.results: a total of 3756 patients were operated. complicationsrelated to the nasal tip such as bossae, bifidity, persistenttip projection or tip asymmetry was seen in 81 patients (2.1%).revisions for tip-related problems were performed in 42 patients(1.1%).conclusions: the findings suggest that the modified verticaldome technique is an effective method for nasal tip deprojectionand narrowing via an open approach. the length of follow-upand the large sample size support effectiveness of the technique