Dynamic rhinoplasty for the plunging nasal tip: functional unity of the inferior third of the nose.

To achieve permanent results for the correction of a drooping nasal tip, it is important to understand the mechanism responsible for the caudal rotation of the tip when a person speaks or smiles. This mechanism can be considered to depend on a "functional unity" formed by three components: (1) the cartilaginous framework (alar cartilages and accessories acting as a single structure); (2) muscular motors (m. levator labii superioris alaeque nasi and depressor septi nasi); and (3) gliding areas (apertura piriformis, the valvular mechanism between the upper lateral cartilages and alar cartilages, the lax tissue of the nasal dorsum, and the membranous septum).

New approach to the gummy smile.

The authors present a multidisciplinary approach to the gingival smile in which its three components are evaluated. These components are the dynamic component of the lip (repose versus smiling) and the two static elements of the gum and maxilla. Once an appropriate diagnosis has been made, the authors act on the gingiva for delayed passive eruption, on the maxilla for long face syndrome, and on the lip with lip-elongation techniques.