Securing nasal tip rotation through suspension suture technique

Multiple techniques have been described to produce tip rotation in rhinoplasty, including the use of sutures, a technique popularized by several authors and shown to be predictable, controllable, and nondestructive. The authors describe a simple procedure for nasal tip rotation with a suture suspension technique through a closed method that allows the nasal tip to be rotated while maintaining its appropriate position.

In each case, after the authors performed standard rhinoplasty techniques, the osteocartilaginous junction was used as an anchor for their suture suspension technique. This technique requires the use of a guide that positions the sutures across the medial side of both domes of the alar cartilages and osteocartilaginous junction.

Between September of 2002 and September of 2004, this technique was used in 30 patients with nasal tip ptosis who requested improvement of this condition. There were 21 primary rhinoplasty and nine secondary rhinoplasty procedures. The results were satisfactory in all of the patients, but four patients had minimal asymmetries of the tip. In the follow-up of these patients, the projection of the nasal tip was maintained long term.

With this suspension suture technique, the authors were able to maintain the optimal position of the nasal tip, using the osteocartilaginous junction as a pillar to provide long-term stability of the nasal tip.