Suture techniques in nasal tip sculpture: current concepts

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.

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

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

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.