New insights into tip supporting structures. Consequences for nasal surgery

Mariola Popko*, Egbert H. Huizing, Dirk J. Menger, Suzanne A.M.W. Verlinde-Schellekens, Claire Mackaaij, Ronald L.A.W. Bleys

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: Knowledge of tip supporting structures is crucial for successful rhinoplastic surgery. The aim of this study was to provide detailed anatomical and histological descriptions of the tip supporting structures. Methods: Serial coronal sections of the entire external noses from seven cadavers were studied after staining by Mallory-Cason and Verhoeff-Van Gieson procedures. Results and conclusions: We found no histological evidence of ligaments between the cartilaginous- and bony parts of the nasal skeleton, and between the skin and the nasal skeleton. Instead, we found a perichondrial-periosteal lining within the soft tissue envelope. The main tip supporting and shaping structures are: Septal and lobular cartilages, premaxillae, and the soft tissue envelope including the periosteal-perichondrial envelope/membrane. These findings may have clinical relevance in functional and aesthetic rhinoplasties.

Original languageEnglish
Pages (from-to)506-515
Number of pages10
Issue number5
Publication statusPublished - 2020


  • Perichondrium
  • Periosteum
  • Rhinoplasty
  • Septum
  • Tip


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