The Fusion Sling Hook Suspension as a Powerful Tool in Tip Support: Surgical Considerations

Tip support in rhinoplasty is one of the main concerns during surgery. The reconstruction of the natural mechanisms of the tip for stabilization has become an increasingly fascinating and critical area of study.This article evaluates the fusion sling hook suspension technique for tip support in rhinoplasties.Prospective observational case series.A prospective analysis of 643 consecutive primary rhinoplasties performed between January 2020 and December 2024 was conducted, during which a careful dissection of the fusion sling anatomy was performed. Of these, 557 cases utilized the fusion sling hook suspension technique. Data were reported in accordance with the STROBE guidelines.The stability provided by the fusion sling hook maneuver proved to be highly effective and durable throughout the observation period. Seven patients (1.3%) who underwent the fusion sling hook suspension demonstrated some degree of loss of tip projection or rotation, among whom four (0.7%) required revision surgery.The fusion sling flap offers stability, biomechanical logic, and anatomical continuity to the tip. Its strategic use can reduce the need for grafting or decrease the mechanical load placed on grafts, prevent late failures, and ultimately offer surgeons a more precise and versatile tool for long-lasting, natural tip projection.