Video 4.16: Blinking Nose Deformity – Diagnosis by Inspection

What this video shows

Prof. Dr. Suleyman Tas named the condition in which the nasal tip acts like a pulsating organ and moves rhythmically with the eyelid movements the blinking nose deformity. Video 4.16 shows how the diagnosis is made simply by inspection while the patient is awake, and it illustrates the muscle responsible, the dilator naris anterior or the transversalis nasalis muscle, contracting unilaterally or bilaterally.

The mechanism is probably the same as that of unintentional facial tics. The clinical importance, explained in the book, is that after rhinoplasty the tip skin may not settle on the supratip groove because the muscle keeps contracting, which leads to a supratip deformity if the condition is not treated (see Video 4.20).

Key points

• Nasal tip moving in rhythm with blinking.

• Responsible muscles: dilator naris anterior or transversalis nasalis.

• Untreated, it causes supratip deformity after rhinoplasty.

For patients: if your nose tip twitches when you blink, tell your surgeon before rhinoplasty; treating it during the operation prevents a bump above the tip later.

In the book: Chapter 4 – Nasal Tip Surgery, section 4.5 Blinking Nose Deformity and Its Treatment – 4.5.1 Surgical Anatomy, pp. 109–110 of Rhinoplasty in Practice: An Algorithmic Approach to Modern Surgical Techniques (CRC Press, 2021). About the book and all companion videos.

Surgeon: Prof. Dr. Suleyman Tas, plastic, reconstructive and aesthetic surgeon, Istanbul. This video is part of the surgeon-training material of the book; patients considering rhinoplasty in Istanbul can use it to understand the techniques used at Prof. Dr. Suleyman Tas Clinic.