Aims and Background: Revision or secondary rhinoplasty involving the nasal tip is challenging due to distorted anatomy, scarring, and compromised tip support. This article presents framework for surgical approach and decision making in secondary rhinoplasty. Historical Aspects: Contemporary principles emphasize stability, conservative cartilage handling, and restoring native architecture. Anatomy: The nasal tip depends on the soft-tissue envelope and lower lateral crura, whose relationship with the septum determine projection, rotation, and contour. Technology: High-resolution photography, endoscopy, and improved grafting materials enhance diagnosis and correction of nasal tip deformities. Patient Selection: Optimal patients should undergo in-depth assessment with special attention to skin thickness, previous complications, and unrealistic expectations. Techniques: Structure and support of the tip cartilages are the foundation and critical for the appearance and longevity of your results. As part of building the structure and support, the lower lateral cartilages can be re-positioned and re-shaped to the ideal appearance. Further refining of definition and contour then occurs with management of the soft tissue envelope being part of the decision process throughout. Postoperative Care: Scar modulation and protection of graft constructs are critical for long-term stability. Current and Future Development: Regenerative therapies, advanced biomaterials, and minimally invasive contour solutions continue to evolve. Conclusions and Clinical Relevance: A regimented, anatomy-driven approach provides consistent and durable outcomes in revision tip rhinoplasty. Keywords: Revision rhinoplasty; nasal tip; secondary rhinoplasty; soft-tissue management. Acknowledgements: AI was not used in manuscript preparation. Conflict of Interest: none declared.
Ramirez et al. (Thu,) studied this question.