What technique is used to create a supratip break?

Question

To create a supratip break does the tip have to be raised? If so how much does this affect the frontal view of the nose. (Will it look upturned?)

William Portuese, MD · Answer

There are many techniques that create the supra-tip break which include trimming the lower lateral cartilages of the nasal tip and shaving down the cartilaginous dorsal hump. A supratip break is only visualized on the three-quarter views and the side view, not from the frontal view.  The tip of the nose does not have to be over -roated and upturned to give a super tip break.  Digital computer imaging would be helpful to understand what can be accomplished with your nose upon your facial features. For more information and many examples of supratip breaks, please see the link and the video below

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. There are many ways to create a supratip break.  It depends on your individual nasal anatomy.  Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and not just a computer animation system. The most important
aspect is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Gregory Turowski, MD, PhD, FACS · Answer

Supratip break is a must feature of almost all good looking noses . Open rhinoplasty provides most predictable results by allowing not only resection (trimming) of the cartilages under direct vision but also providing access for support grafts and structural sutures. Just like structural solid rhinoplasty is cruicial for good results so is properly placed splint - eliminating "dead space" in the supratip area

Michael A. Epstein, MD, FACS · Answer

Thank you for your question.The supratip break is created through a combination of reduction of the dorsal nasal hump, trimming of the lower lateral cartilages, and placement of cartilage grafts at the tip (depending on what's actually needed to create the effect).  I recommend you consult with an experienced rhinoplasty surgeon who will come up with a good plan depending on what your nose needs to achieve the result you desire.Best,Dr. Michael EpsteinMAE Plastic SurgeryNorthbrook, IL

Mark Baldwin, MBBS · Answer

A supratip break is a function of the relative projection of the tip vs the dorsum, multiplied by the thickness of the skin. I surmise by 'raise the tip', you're asking does the tip have to be rotated cephalad to create a supratip break. Firstly, everything affects the front view of the nose. Secondly, rotating the tip cephalad does make the nose look more upturned. But surgeons don't 'raise the tip' to create a supratip break. They 'raise the tip' when it isn't in the right spot. If it is already in the right spot, and you want a supratip break, surgeons do something else to create it. So the bottom line answer to your question is 'Maybe'.

Peter E. Johnson, MD · Answer

The supra tip break is the slight projection of the tip above the bridge of the nose, and can be produced by many methods including the support of the tip, tip rotation, or reduction of the bridge. The nose need not be short or upturned to have a very nice profile and supra tip break.

Gaby D. Doumit, MD · Answer

Thank you for sharing your concerns.  Supratip break is created by having the tip of the nose and inferior portion of the dorsum at different height.Hence you can reduce the heigh of the dorsum if it is too high or increase the tip projection if it is too lowGood Luck

Edward Farrior, MD · Answer

Rather or not the tip needs to be raised to create a supra-tip break depends on the height of the nasal dorsum. A supra-tip break can be created by trimming of the upper margin of the lateral crus of the lower lateral cartilage, or adding a piece of cartilage to the tip in the form of a cap graft or shield graft. The technique choose depends on a lot of factors including the strength of the cartilage and the thickness of the skin. It also may depend on the presence or absence of a bump. The nose can not be evaluated as individual components but the sum of all portions and their overall contribution to the whole. Most rhinoplasties will require that multiple components are addressed, nothing exist in isolation, if treated as though they do an unacceptable outcome can be expected.

Richard W. Fleming, MD (retired) · Answer

A supra tip break can be created by increasing tip rotation or projection or by lowering the dorsum above the tip. I need to see pictures as described on my website to make specific recommendations for your nose.

What technique is used to create a supratip break?

Answers (9)

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