Increasing the tip projection and rotation in rhinoplasty is a frequently performed and well-known topic. However, when it comes to a high projection and also a bulbous tip structure, it is difficult to correct this pathology and this issue is one of the insufficiently clarified challenges of Rhinoplasty. In these kinds of cases, the patient already has a high and wide nasal tip. Since deprojection is a maneuver that widens the nasal tip and base, it becomes difficult to manage the nasal tip, which is already wide at the beginning. Therefore, it is one of the challenges of rhinoplasty. We would like to share with the participants how we manage such noses in the light of our experiences and current literature with case presentations.

Septal extension grafts play a pivotal role in controlling nasal tip projection and rotation in rhinoplasty. Achieving ideal nasal tip positioning is essential for facial harmony and patient satisfaction. This can be accomplished by balancing nasal length, projection, and rotation. Septal extension grafts, typically harvested from the patient’s own septal cartilage, offer a reliable method for extending the caudal septum and reinforcing nasal tip support. They are commonly preferred due to their structural strength and versatility. This panel will explore the various types of septal extension grafts, their design options, and indications. Practical considerations, including patient selection, surgical technique, and complications, will also be discussed. Emphasis will be placed on integrating functional and aesthetic outcomes through evidence-based practices. Participants will gain insight into optimizing nasal tip outcomes using different graft configurations in diverse clinical scenarios.

Rhinoplasty surgery has been increasingly performed in recent years and is among the most commonly performed surgeries today. As a result of such a high number of rhinoplasty surgeries, complications and problems have also increased at a similar rate and revision surgeries have become important. The main limitations in revision rhinoplasty are mucosa and skin. Problems such as serious mucosa and skin losses, skin collapses due to infection and abscesses, nostril over resections, severe retractions and serious deformities due to skin necrosis are considered under the title of extreme revisions. Almost half of the rhinoplasties we perform in our clinic are revision cases. We have significant experience with such extreme revisions. We would like to share our experiences with the participants with case examples.

The nose framework is an important structure that carries the nose, gives the nose its shape and provides breathing properly to pass through it. It is important for nasal surgeries to be performed it with appropriate strength and regularity. One of the most frequent and important reasons for revisions of nasal surgeries is an insufficiently strong and unbalanced nose framework. The reason for important pathologies such as nostril asymmetries, pinching deformity, Polly beak deformity, saddle nose deformity, and nasal valve collapse that we frequently see in revision cases is that the nose framework does not have sufficient strength and regularity. In almost all cases opened for revision, there is a need to correct the nose skeleton. Therefore, in revision surgeries, the most important stage of achieving aesthetic and functional progress is to reconstruct the nose framework. In this presentation, we would like to convey our approach and experience on this subject to the participants with both surgery videos and animation videos of our techniques, some of which have been published in international journals.

tip surgery is an important part of rhinoplasty, different techniques can be used to obtain good results , this round table will discuss about techniques and outcomes