Pitanguy Ligament Preservation in Structural Precision Rhinoplasty.

The Pitanguy ligament is a crucial structure in nasal tip support and in maintaining the integrity of the soft-tissue envelope of the nose. In this cadaveric study, the authors dissected out the Pitanguy ligament on a series of fresh human cadaver specimens to elucidate the structure of the ligament and its fate in open rhinoplasty. The Pitanguy ligament can act as a tethering force to the nasal tip when reshaping the nasal tip. Release of the Pitanguy ligament alleviated downward tension on the nasal tip, and tip shaping to a more appropriate position demonstrated that this ligament was displaced from its ideal position. In patients seeking rhinoplasty, this structure may require release and reconstruction to successfully alter tip position and avoid supratip deformity.