Download PDF
Arquivos Internacionais de Otorrinolaringologia 2011; 15(03): 302-307
DOI: 10.1590/S1809-48722011000300006
Original Article
Thieme Publicações Ltda Rio de Janeiro, Brazil

Nasal tip narrowing: Minimally invasive suture technique for thick nose tip

Refinamento da ponta nasal: Técnica de sutura minimamente invasiva para a ponta nasal larga
Antonio Celso Nunes Nassif Filho
1   Doctor in Medicine from UFPR. Professor at PUC/PR, Coordinator of the Medical Residency in Otorhinolaryngology at Paraná's Red Cross Hospital.
,
Giovana Romano
2   Specialist in Surgical Plastic - AMB / CFM /SBCP. Plastic Surgeon Doctor.
,
Denise Braga Ribas
3   Doctor attending Specialization Degree in Otorhinolaryngolgogy at Paraná's Red Cross Hospital. Junior Doctor.
,
Scheila Maria Gambeta Sass
4   Specialist in Otorhinolaryngolgogy and Facial Cervical Surgery. Otorhinolaryngologist Doctor.
,
Emerson Franceschi
5   Doctor
› Author Affiliations
Further Information

Publication History

27 January 2011

19 April 2011

Publication Date:
12 February 2014 (online)

   Permissions and Reprints

Summary

Introduction: Suture techniques are mandatory methods to shape the nasal cartilages. For purposes of achieving a better contour on thick or globose nasal tips, the authors have approached a controlled intercrural and minimally invasive suture technique and the results obtained by submitting 34 patients to rhinoplasty.

Objective: Illustrate the intercrural suture technique as a treatment for a thick or globose nasal tip under closed rhinoplasty and explain the esthetical results.

Method: Retrospective study with 34 patients' clinical documents and photographs (5 male and 20 female) aged between 16 and 52, who were submitted to the thick or globose nasal tip rhinoplasty as an anatomic element found in the physical examination. In all the cases, closed rhinoplasty technique was used. A suture that cannot be absorbed is performed throughout the intermediate process. The study was performed at the Brazilian Red Cross Hospital in the State of Paraná and Sugisawa Hospital in 2009 and 2010. Patients were operated on by the main author and the junior doctors under training.

Results: The controlled intercrural suture enabled the nasal tip to be narrowed and improved the shape in the frontal and lateral angles of the nasal tip.

Conclusion: Controlled intercrural suture is a minimally invasive method providing the thick nasal tip narrowing with satisfactory results.

Resumo

Introdução: Técnicas de sutura são métodos indispensáveis para esculpir as cartilagens nasais. Para obter um melhor contorno em pontas nasais largas ou globosas os autores apresentam uma técnica de sutura intercrural controlada e minimamente invasiva e os resultados obtidos em 34 pacientes submetidos a rinoplastia.

Objetivo: Demonstrar a técnica de sutura intercrural como tratamento para a ponta nasal larga ou globosa em rinoplastia fechada e apresentar os resultados estéticos.

Método: Estudo retrospectivo de documentos clínicos e fotografias de 34 pacientes (5 homens e 29 mulheres), com idade entre 16 e 52 anos, submetidos a rinoplastia com ponta nasal larga ou globosa como elemento anatômico presente no exame físico. Em todos os casos foi utilizada técnica de rinoplastia fechada. Uma sutura inabsorvível é realizada ao longo do processo intermédio. O estudo foi conduzido em 2009 e 2010 no Hospital da Cruz Vermelha Brasileira - Filial do Paraná - Brasil e no Hospital Sugisawa. Os pacientes foram operados pelo autor principal e pelos médicos residentes em treinamento.

Resultados: A sutura intercrural controlada proporcionou uma refinamento da ponta nasal e uma melhor forma nos ângulos frontal e lateral da ponta nasal.

Conclusão: A sutura intercrural controlada é um método minimamente invasivo que oferece resultados satisfatórios em refinamento da ponta nasal larga

Keywords

rhinoplasty - nasal cartilage - suture techniques - minimally invasive surgical procedures

Palavras-chave

rinoplastia - cartilagens nasais - técnicas de sutura - procedimentos cirúrgicos minimamente invasivos
 

  • References

  • 1 Behmand RA, Ghavami A, Guyuron B. Nasal tip sutures, part I: the evolution. Plast Reconstr Surg 2003; 112 (4) 1125-29
    CrossrefGoogle Scholar
  • 2 Tebbetts JB. Shaping and positioning the nasal tip without structural disruption: a new, systematic approach. Plast Reconstr Surg 1994; 94 (1) 61-77
    CrossrefGoogle Scholar
  • 3 Fuleihan NS. The Transvestibular Approach: A new horizon in Rhinoplasty. Arch Facial Plast Surg 2006; 8 (4) 273-82
    CrossrefGoogle Scholar
  • 4 Peck GC. Techniques in aesthetic rhinoplasty, 2nd ed. New York: Thieme-Stratton; 1990
    Google Scholar
  • 5 McCollough EG, English JL. A new twist in nasal tip surgery: an alternative to the Goldman tip for the wide or bulbous lobule. ArchOtolaryngol 1985; 111 (8) 524-9
    Google Scholar
  • 6 Baker SR. Suture contouring of the nasal tip. Arch Facial Plast Surg 2000; 2 (1) 34-42
    CrossrefGoogle Scholar
  • 7 Leach JL, Athré RS. Four suture tip rhinoplasty: a powerful tool for controlling tip dynamics. Otolaryngol Head Neck Surg 2006; 135 (2) 227-31
    CrossrefGoogle Scholar
  • 8 Tardy ME, Cheng E. Transdomal suture refinement of the nasal tip. Facial Plast Surg 1987; 4 (4) 317-26
    Article in Thieme ConnectGoogle Scholar
  • 9 Papel ID. Interlocked transdomal suture technique for the wide interdomal space in rhinoplasty. Arch Facial Plast Surg 2005; 7 (6) 414-17
    CrossrefGoogle Scholar
  • 10 Kridel RW, Konior FJ, Shumrick KA, Wright WK. Advances in nasal tip surgery: the lateral crural steal. Arch Otolaryngol Head Neck Surg 1989; 115 (10) 1206-12
    CrossrefPubMedGoogle Scholar
  • 11 Daniel RK. Tip Refinements Grafts: The designer Tip. Aesthet Surg J 2009; 29 (6) 528-37
    CrossrefGoogle Scholar
  • 12 Mocellin M, Pasinato R, Berger CAS, Soares CMC, Grinfeld A, Fagundes MSC. Estreitamento da Base Nasal no Nariz Caucasiano através da técnica de Cerclagem. Arch Otolaryngol 2010; 4 (3) 199-205
    Google Scholar
  • 13 Daniel RK. Rhinoplasty: creating an aesthetic tip: a preliminary report. Plast Reconstr Surg 1987; 80 (6) 775-83
    CrossrefGoogle Scholar
  • 14 Converse JM. Corrective rhinoplasty. In: Converse JM. Reconstructive Plastic Surgery. Philadelphia, Pa: WB Saunders Co.; 1977. 2. 1091-3
    Google Scholar
  • 15 Toriumi DM. New Concepts in Nasal Tip Contouring. Arch Facial Plast Surg 2006; 8 (3) 156-185
    CrossrefGoogle Scholar
  • 16 Gruber RP, Friedman GD. Suture algorithm for the broad or bulbous nasal tip. Plast Reconstr Surg 2002; 110 (7) 1752-64
    CrossrefGoogle Scholar
  • 17 Corrado A, Bloom JD, Becker DG. Domal Stabillization Suture in Tip Rhinoplasty. Arch Facial Plast Surg 2010; 11 (3) 194-7
    Google Scholar
  • 18 Mocella S, Bianchi N. Double interdomal suture in nasal tip sculpturing. Facial Plast Surg 1997; 13 (3) 179-96
    Article in Thieme ConnectGoogle Scholar