Nasal tip dynamics

In rhinoplasty, the nasal tip remains the most challenging anatomic region to diagnose and treat. This article presents a new concept, the M-arch model, to better understand the functional and aesthetic anatomy of the tip. This M-arch can be lengthened or shortened, or left as is, to establish the basis of ideal nasal length, projection, and rotation. Additional suture, incisional, excisional, and grafting maneuvers can be performed in a graduated fashion to further refine the M-arch, including the lobule and soft tissue of the nasal base. A full description of the M-arch model and its application is presented, and representative results are illustrated.