The nose is made up of a fixed and rigid part that is called nasal pyramid, although it rather has the shape of a tent or roof, and a pliable mobile part which is the nasal tip, the alae and its annexes. The nasal tip and the alae are structured by the so called alar or lower lateral horseshoe shaped cartilages with their lateral and medial crura or crus and accessory cartilages, the domes between lateral and medial cruras, the interdomal fibrofatty pad, the caudal or lower septum and the skin of the alae.
Both halves of the nasal tip join with each other in the center of the tip to form a tripod in which the lateral legs are the lateral cruras of the alar or lower lateral cartilages and the central leg the union of both medial cruras of the alar or lower lateral cartilages.
We consider the nasal tip is poorly defined when its external look is not the canonical pentagon, the contour is erased, is flattened and lacks the adequate prominence ridges, which might be caused by one or more of congenital or ethnically conditioned misshaped cartilages, excessive fibrofatty pad, thick skin, poor tip support, untreated anatomical nasal issues, aging, etc. This leads to a typical undefined or amorphous nasal tip shape with absence of the essential anatomical relieves, lack of suitable femininity in women and an unsightly look in men.
Treatment of undefined nasal tip has to be customized to each individual situation, being the main pillar the techniques of nasal tip grafting, with or without reinforcement of tip support with columellar strut.