Double interdomal suture in nasal tip sculpturing

The authors stress that conservative correction should be the main goal in rhinoplasty in general and in the surgical treatment of the nasal tip in particular. After outlining contemporary concepts and criteria relating to the modeling of an aesthetically pleasing nasal tip and the consequent surgical planning for its achievement as well as the specific indications for tip plasty, they go on discuss the technical aspects of tip projection and rotation. A personal technique is proposed for reshaping and sculpturing the tip, completed by a double interdomal suture with different application points during closed rhinoplasty. The technique also involves ancillary procedures consisting in the execution of a series of incisions with a radial pattern at the domal level and, when necessary, in the undersurface of the lateral crus. The procedure is explained in detail and the results are illustrated and discussed.