Transdomal tip plasty scoring is an essential tool in structure, ethnic, custom, revision and reconstructive rhinoplasties, whenever the tip needs to be partially, subtotally or totally redesigned, providing the location, prominence, shape, size, angle or specific custom look desired by the patient or deemed technically required by the surgeon, from a subtle change up to a totally brand new custom made tip; common indications are the poorly defined tip, tip bossing, bulbous tip, boxy tip, aging tip, tip asymmetries, ethnic noses, revision of poor results, feminization cases, etc.
It is considered a highly demanding technique of high difficulty of calibration but of low to medium difficulty in its execution, short time consuming in the operating room and pretty much artistic in terms of its versatility, allowing full deployment of creativity reshaping noses.
This gesture can be done by either closed or open approach rhinoplasties, notwithstanding the open approach is a must of safety, reliability and precision for its execution.
Patients warning: only highly experienced surgeons who have underwent optimal training and have performed already a large number of closed and open approach structure and non structure rhinoplasties should execute high end rhinoplasty cases, should they feel capable and comfortable with the challenge.