The Boxy or Trapezoidal Tip Rhinoplasty

Ideally the nasal tip when viewed from the base view forms a equilateral triangle. In some patients with a bulbous nasal tip the nasal cartilage are quite broad. This results in what is called a boxy or trapezoidal tip. The schematic below illustrates this type of cartilage arrangement.

Schematic of a boxy or trapezoidal nasal base

Tip narrowing techniques to improve this boxiness can include cephalic trimming of the lower lateral cartilages, removal of soft tissue from between the tip cartilages, and placement of an interdomal suture to bring the nasal tip defining points (domes) closure together. Also, techniques used to flatten overly convex lower lateral cartilages can also help to narrow a broad nasal tip. The schematic below shows a more ideally situated dome complex:

Ideal equilateral triangle of the nasal base

Before and After Boxy Tip Rhinoplasty Example Photos

Below are a few before and after base photos of patients who had their boxy tips improved with rhinoplasty:

Boxy tip repair using inerdomal suture and cephalic trim
Boxy tip repair using interdomal suture and cephalic trim
Trapezoidal tip repair using cephalic trim, interdomal suture and LLC strut grafts
Trapezoidal tip repair using LLC strut grafts, cephalic trim and intermodal suture
Boxy tip repair using LLC strut grafts, interdomal suture and cephalic trimRhinoplasty patient 44 frontal before and after boxy tip repair.jpgRhinoplasty patient 44 base before and after boxy tip repair Rhinoplasty patient 52 boxy tip repair base view before and after

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