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  Tip nose : The most crucial part of rhinoplasty
Nasal tip plasty is the most crucial part of rhinoplasty that requires meticulous works to get the best result. Due to different type of Asians nose, nasal implant alone is quite difficult to obtain the optimum refinement in tip area. Unlike Caucasians, Asian noses have thicker skin, weak and thin cartilage, retracted columella and blunt alar lobule producing the up-turned nose, short nose and bulbous nose.
To successful refinement the Asians’ nasal tip, the fully anatomic understanding and proper surgical techniques are utmost necessary.
Tip Suturing
Tip suturing is a basic procedure to refine the shape of tip cartilage. Several suturing techniques are used to reshape and to support the nasal tip structure. Thicker skin and small cartilage are the limited factors for successful procedure by simple suturing technique alone.
Cartilage Graft
Cartilage graft is the most popular technique in Asians rhinoplasty to reshaping the tip and lengthening the nose. The cartilage that is harvested from the nasal septum or ear is frequently used at the nasal tip plasty. Many kinds of grafts are used according to its function to support the tip like as shield graft, on-lay graft, columellar strut graft and septal extension graft. Combination of suturing technique and cartilage graft is often performed to get the pleasing tip nose.
Cartilage modification and thinning skin envelope at tip nose are also important procedures in nasal tip plasty.
To create the designed nose, tip plasty is always done at the same time of augmentation rhinoplasty.
The advantage of tip rhinoplasty is that the nasal tip can be positioned at the ideal angle with the ideal shape in the way that the patient desires.

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