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Primary mechanisms of nasal tip rotation
Nasal tip rotation is governed by the lower lateral cartilages, the caudal septum, and skin tension; it is increased by reshaping those structures (surgically) or, mildly, by volume and taping methods.
- Lower Lateral Cartilages (LLC): The shape, strength, and vector of growth of the LLCs directly determine whether the tip points up or down.
- Cartilaginous Septum: The length and angle of the caudal septum act as the main tent pole. If the cartilage grows excessively long, it forces the tip downward.
- Fibrous Suspensory Ligaments: The connections between the upper and lower cartilages hold the tip up against gravity.
Secondary foundation: maxillary morphology
- Anterior Nasal Spine (ANS): This bony projection of the maxilla serves purely as the anchor point for the cartilaginous base.
- Foundation Tilt: The maxilla sets the baseline angle. If a person has a severe skeletal structural issue like vertical maxillary excess, it changes the foundation tilt, secondarily affecting how the tip sits.