See how a cephalic trim can be used to reduce the roundedness and fullness of the nasal tip.
In Part 1 of a Bulbous Nasal Tip Case Study, Thomas Lamperti, MD, uses a novel, high definition point-of-view camera to narrate an intra-operative video that shows how he performs a cephalic trim in order to improve the appearance of a bulbous nasal tip.
"This is Seattle facial plastic surgeon, Dr. Thomas Lamperti. Today I'm going to show you how to perform a cephalic trim of the lower lateral cartilages in order to treat nasal tip bulbosity. To start I'm first using a caliper to measure how much lower lateral crura I want to maintain. I follow a conservative approach which favors maintaining nasal structural support so I usually leave from 8 to 10 millimeters at the widest point of the crura. In this patient I'm leaving 10 millimeters. As I approach the dome defining points I usually leave from 5 to 7 millimeters. Once the cartilage is incised, I then separate the cartilage from the underlying nasal skin lining or mucosa. I normally store the removed lower lateral crural cartilage in some saline in case I want to use it later in the procedure for grafting. Next, I'll repeat the procedure on the patent's left side. Of course, for symmetry I use the same measurements as I did on the right side. The cephalic trim is one useful step in reducing the fullness of the nasal tip. The main goal in obtaining a aesthetically pleasure tip contour is creating a flattened lower lateral crura. Once the overall volume of the tip is improved with the cephalic trim we can then proceed with further modifying the tip cartilage positioning. In part 2 of this patient's case study I'll show you how to use dome binding sutures to further treat the bulbous nasal tip."
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