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Int Arch Otorhinolaryngol 2012; 16(03): 391-395
DOI: 10.7162/S1809-97772012000300015
Review Article
Thieme Publicações Ltda Rio de Janeiro, Brazil

Nose tip refinement using interdomal suture in caucasian nose

Rogério Pasinato
1   Master. Associate Professor, Department of Otorhinolaryngology, Federal University of Paraná (UFPR). Doctor's ENT Hospital IPO.
,
Marcos Mocelin
2   Doctor. Professor, Department of Otorhinolaryngology, Federal University of Paraná (UFPR). Otolaryngologist Hospital IPO.
,
Cezar Augusto Sarraf Berger
3   Master in Surgery. Volunteer lecturer, Department of Otolaryngology, Federal University of Paraná (UFPR). Otolaryngologist Hospital IPO.
› Author Affiliations
Further Information

Publication History

31 October 2011

06 February 2012

Publication Date:
05 December 2013 (online)

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Summary

Introduction: Refinement of the nose tip can be accomplished by a variety of techniques, but currently, the use of sutures in the nasal tip with conservative resection of the alar cartilage is the most frequently recommended approach.

Objective: To classify the nasal tip and to demonstrate the interdomal suture applied to nasal tip refinement in the Caucasian nose, as well as to provide a simple and practical presentation of the surgical steps.

Method: Development of surgical algorithm for nasal tip surgery: 1. Interdomal suture (double binding suture), 2. Interdomal suture with alar cartilage weakening (cross-hatching), 3. Interdomal suture with cephalic removal of the alar cartilage (McIndoe technique) based on the nasal tip type classification. This classification assesses the interdomal distance (angle of domal divergence and intercrural distance), domal arch width, cartilage consistency, and skin type. Interdomal suture is performed through endonasal rhinoplasty by basic technique without delivery (Converse-Diamond technique) under local anesthesia.

Conclusion: This classification is simple and facilitates the approach of surgical treatment of the nasal tip through interdomal suture, systematizing and standardizing surgical maneuvers for better refinement of the Caucasian nose.

Keywords

rhinoplasty - suture techniques - nose
 

  • References

  • 1 Maniglia AJ, Maniglia JJ, Maniglia JV. Rinoplastia Estética-Funcional-Reconstrutora. 1ª ed. Revinter 2002; 129-150
    Google Scholar
  • 2 Corrado A, Bloom J, Becker D. Domal Stabilization Suture in Tip Rhinoplasty. Arch Facial Plast Surg 2009; 11 (3) 194-7
    CrossrefGoogle Scholar
  • 3 Tardy ME, Brown RJ. Surgical anatomy of the nose. New York: Raven Press; 1990
    Google Scholar
  • 4 Rohrich RJ, Adams WP. The Boxy Nasal Tip: Classification and Management Based on Alar Cartilage Suturing Techniques. Plast Reconst Surg 2001; 1849: 107
    Google Scholar
  • 5 Tebbetts JB. Discussion:nasal tip sutures part I: the evolution. Plast Reconst Surg 2003; 12 (8) 1146-9
    Google Scholar
  • 6 Guyuron B, Behmand R. Nasal tip sutures part II: the interplays. Plast Reconst Surg 2003; 12 (8) 1146-9
    Google Scholar
  • 7 Lo S, Rowe-Jones J. Suture techniques in nasal tip sculpture: current concepts. J Laryngol Otol 2007; 121 (8) e10
    CrossrefGoogle Scholar
  • 8 Gruber R, Weintraub J, pomerantz J. Sutura Techniques for Nasal Tip. Aesthetic Surg J 2008; 28: 92-100
    CrossrefGoogle Scholar
  • 9 Perkins S, Patel A. Endonasal Suture Techniques in Tip Rhinoplasty. Facial plast Surg Clin North Am 2009; 17 (1) 41-54
    CrossrefGoogle Scholar
  • 10 Leach JL , Athré. Four suture tip rhinoplasty: A powerful tool for controlling tip dynamics. Otol Head Neck Surg 2006; 135: 227-31
    CrossrefGoogle Scholar