Tip Grafting for the Asian Nose.

Tip surgery during rhinoplasty is particularly difficult in Asians. Tip grafting is the best approach. Conchal cartilage with perichondrium and costal cartilage are powerful grafting materials. The most important grafting techniques are tip-onlay grafting, shield grafting, and multilayer tip grafting. Tip-onlay grafts are useful for dorsal convexity. Shield grafts require sufficient support to prevent bending. Multilayer tip grafts (usually 2 layers) are versatile. Asians vary in cartilage configuration, skin thickness, and aesthetic desires: tip-grafting strategies must be tailored to meet the aesthetic goals of individuals. Tip-grafting complications (eg, visible graft contour and infection) are not uncommon and should be considered.