A New Twist in Nasal Tip Surgery: An Alternative to the Goldman Tip for the Wide or Bulbous Lobule

When the cartilaginous framework in the tip of the nose fails to provide adequate support and definition, the rhinoplastic surgeon must create strength and refinement. To achieve these results, we advocate a new twist of an old concept that can be used to create a stronger, more triangular lobule in the wide, bulbous, or bifid tip. Morselizing, incising, and suturing alar cartilages have long been recognized as adjunctive procedures in tip rhinoplasty; however, the specific method described herein can provide results comparable to the classic Goldman tip while guarding against the possibility of cartilage displacement and mucous membrane entrapment.