Figure 7: Causes and development of the “pollybeak-deformity“.
a) Risk-factors are deep nasofrontal angle (1), high cartilaginous dorsum (2) and under-projection of nasal tip (3).
b) Lowering of the dorsum by resection of the septo-dorsal-cartilage (4) and tip rotation by resection of the lateral crus (5) and a triangular part of the caudal septum (6).
c) Immediately postoperative overprojection of the nasal tip (7) in relation to nasal dorsum (8).
d) Development of the pollybeak-deformity by the dynamic healing process resulting in a decreased tip projection (7) in relation to the level of nasal dorsum (8). The cartilaginous dorsum is the most prominent part, sometimes exaggerated by subcutaneous scar formation in the supratip area (9) (so called “soft tissue polly-beak”).