Suture tip plasty

The three main characteristics of the nasal tip are projection, rotation, and contour. During rhinoplasty the surgeon will strive to preserve or change these characteristics in a predictable fashion, avoiding undesirable sequelae, even after long-term follow-up. Conservation, relocation and augmentation rather than reduction are key principles in modern rhinoplasty, i.e. for obtaining gratifying tip surgery. Interdomal suture, transdomal suture, and lateral crural steal follow these modern principles, while having their clear indications for different nasal tip pathology. All three types of techniques involve (semi-)permanent sutures to change the shape of alar cartilages and can be considered complementary. Based on the same surgical philosophy these three techniques can be captured with the term "suture tip plasty". The objective of this paper is to describe, in a retrospective fashion, a series of 112 patients in whom suture tip plasty has been used as part of the rhinoplasty procedure. The technique proved versatile with predictable results and few manageable complications.