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Suture techniques in nasal tip sculpture: current concepts

Published online by Cambridge University Press:  07 June 2007

S Lo  and
J Rowe-Jones
S Lo*
Affiliation:
Department of Otorhinolaryngology – Facial Plastic Surgery, Royal Surrey County Hospital, Guildford, UK.
J Rowe-Jones
Affiliation:
Department of Otorhinolaryngology – Facial Plastic Surgery, Royal Surrey County Hospital, Guildford, UK.
*
Address for correspondence: Mr Stephen Lo, 4 Osborne Road, Farnborough GU14 6PT, UK. Fax: +44 1483 464108 E-mail: [email protected]
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Abstract

Objectives:

The three-dimensional anatomy and conspicuous location of the nasal tip makes it one of the most challenging sites of facial plastic surgery. This article reviews literature on nasal tip sculpture using suture techniques, as well as the authors' own experience.

Methods:

A search was conducted using Pubmed, the Google internet search engine and the authors' files, using the keywords ‘nasal tip’, ‘suture’, ‘rhinoplasty’ and ‘septorhinoplasty’.

Results:

Common nasal tip suture techniques and suture algorithms are presented, along with a summary of the indications and side effects of each technique.

Conclusions:

Predictable long-term results are more likely to occur with minimal local tissue excision. Suture techniques remodel the shape of the nasal tip by altering the configuration of, and the relationship between, the tip cartilages and their supporting structures; they also preserve nasal tip anatomy and limit resection. Intra-operatively, the effects are immediately visible, and can be adjusted or reversed. Tip sutures should therefore be considered instead of tissue excision whenever possible.

Keywords

RhinoplastyNasal TipSutureRhinoplastySeptorhinoplasty
Type
Online Only Main Article
Information
The Journal of Laryngology & Otology , Volume 121 , Issue 8 , August 2007 , E10
Copyright
Copyright © JLO (1984) Limited 2007

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References

1Tardy, ME Jr, Heinrich, JA, Lindbeck, EO. Refinement of the nasal tip. Facial Plast Surg Clin North Am 1994;2:459–76CrossRefGoogle Scholar
2Guyuron, B, Behmand, RA. Nasal tip sutures part II: the interplays. Plast Reconstr Surg 2003;112:1130–45; discussion 1146–9CrossRefGoogle ScholarPubMed
3Tebbetts, JB. Shaping and positioning the nasal tip without structural disruption: a new, systematic approach. Plast Reconstr Surg 1994;94:61–77CrossRefGoogle ScholarPubMed
4Tebbetts, JB. Secondary tip modification: shaping and positioning in the nasal tip using nondestructive techniques. In: Tebbetts, JBed. Primary Rhinoplasty: a New Approach to the Logic and the Techniques. St Louis: Mosby, 1998;261–440Google Scholar
5Sheen, JH, Sheen, AP. Aesthetic Rhinoplasty, 2nd edn. St Louis: Mosby, 1987Google Scholar
6McCollough, EG, English, JL. A new twist in nasal tip surgery. An alternative to the Goldman tip for the wide or bulbous lobule. Arch Otolaryngol 1985;111:524–9CrossRefGoogle ScholarPubMed
7Tardy, ME Jr, Patt, BS, Walter, MA. Transdomal suture refinement of the nasal tip: long-term outcomes. Facial Plast Surg 1993;9:275–84CrossRefGoogle ScholarPubMed
8Daniel, RK. Rhinoplasty: creating an aesthetic tip. A preliminary report. Plast Reconstr Surg 1987;80:775–83CrossRefGoogle Scholar
9Kridel, RW, Konior, RJ, Shumrick, KA, Wright, WK. Advances in nasal tip surgery. The lateral crural steal. Arch Otolaryngol Head Neck Surg 1989;115:1206–12CrossRefGoogle ScholarPubMed
10Baker, SR. Suture contouring of the nasal tip. Arch Facial Plast Surg 2000;2:34–42CrossRefGoogle ScholarPubMed
11Kridel, RW, Scott, BA, Foda, HM. The tongue-in-groove technique in septorhinoplasty. A 10-year experience. Arch Facial Plast Surg 1999;1:246–56CrossRefGoogle Scholar
12Daniel, RK. Rhinoplasty: a simplified, three-stitch, open tip suture technique. Part I: primary rhinoplasty. Plast Reconstr Surg 1999;103:1491–502CrossRefGoogle ScholarPubMed
13Daniel, RK. Rhinoplasty: a simplified, three-stitch, open tip suture technique. Part II: secondary rhinoplasty. Plast Reconstr Surg 1999;103:1503–12CrossRefGoogle ScholarPubMed
14Rohrich, RJ, Adams, WP Jr.The boxy nasal tip: classification and management based on alar cartilage suturing techniques. Plast Reconstr Surg 2001;107:1849–63; discussion 1864–8CrossRefGoogle ScholarPubMed
15Gruber, RP, Friedman, GD. Suture algorithm for the broad or bulbous nasal tip. Plast Reconstr Surg 2002;110:1752–64; discussion 1765–8CrossRefGoogle ScholarPubMed
16Tebbetts, JB. Discussion: nasal tip sutures part i: the evolution nasal tip sutures part ii: the interplays; Guyuron B, and Behmand RA. Plast Reconstr Surg 2003;112:1146–9CrossRefGoogle Scholar
17Rohrich, RJ, Raniere, J Jr, Ha, RY. The alar contour graft: correction and prevention of alar rim deformities in rhinoplasty. Plast Reconstr Surg 2002;109:2495–505CrossRefGoogle ScholarPubMed
18Toriumi, DM. Structure approach in rhinoplasty. Facial Plast Surg Clin North Am 2005;13:93–113CrossRefGoogle ScholarPubMed
19Toriumi, DM. New concepts in nasal tip contouring. Arch Facial Plast Surg 2006;8:156–85CrossRefGoogle ScholarPubMed
20Becker, DG, Pastorek, NJ. The radix graft in cosmetic rhinoplasty. Arch Facial Plast Surg 2001;3:115–19CrossRefGoogle ScholarPubMed
21Sheen, JH. Rhinoplasty: personal evolution and milestones. Plast Reconstr Surg 2000;105:1820–52; discussion 1853CrossRefGoogle ScholarPubMed