Fig. 10.

Illustration of the plunging tip deformity secondary to skeletal aging. Note derotation of the nasal tip with an acute nasolabial angle due, in part, to posterior and superior atrophy of the pyriform aperture. Correction of the plunging tip includes tip rotation through alteration of the nasal base/pyriform aperture and the tip complex. Reprinted with permission from Pessa JE, Peterson ML, Thompson JW, et al. Pyriform augmentation as an ancillary procedure in facial rejuvenationsurgery. Plast Reconstr Surg. 1999;103:683–686.¹²