Asymmetrical Nasal Tip

Facial asymmetries are quite prevalent in the general population. Therefore, when assessing patients with nasal tip asymmetry, it is crucial to analyze the entire face. Because the majority of patients focus only on their noses, the surgeon may be telling them about their facial asymmetries for the first time. Nevertheless, patients must be informed preoperatively that restoring a symmetrical nasal tip may not always be possible when the face is asymmetrical. All patients seeking rhinoplasty must undergo intranasal examination on a routine basis. Intranasal examination must be performed with extra caution in patients presenting with tip asymmetry. The caudal septum must be assessed in detail because the asymmetrical tip may result from septal or caudal septal deviation. As previously discussed, the caudal septum serves as the base, where the tip rests. The relationship between the caudal septum and the tip is so critical that any pathology present in the septum may have a direct effect on the tip. One condition where this relationship becomes evident is the asymmetrical nasal tip. Any deviation in the caudal septum affects the tip directly. This applies even when the alar cartilages underlying the nasal tip are totally symmetrical. The trick in creating a symmetrical tip lies in repositioning the septum in the midline. Therefore, every surgeon performing rhinoplasty must master the technical skills and acquire the experience needed to bring the caudal septum to the midline.