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>> Dr. Lamperti: 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.
www.drlamperti.com