Rhinoplasty operation - What are these 2 operations do in rhinoplasty?

Transom and interdome suture Tongue In groove I had a nose surgery back home n very unhappy with my results ! Short upturned nose ! Thinking for revision soon ! I appriciate your answers in advance

Doctor Answers 8

Rhinoplasty techniques

When a rhinoplasty surgeon examines a nose in the office, they begin to develop a surgical plan. The best way to think of refining the tip is to think of the procedures ranging from conservative to more aggressive- almost like going up a flight of stairs. In surgery, often we start with the most conservative approach and see if it achieves our goal. If it doesn't, then we proceed to the next level procedure. Transdomal and interdomal sutures are in the middle of the available procedures to narrow the tip. I would share your concerns with your rhinoplasty surgeon. It is important to wait a year before any revision.


Atlanta Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

You shouldn't be the one to decide on a particular surgical technique

Even a surgeon frequently doesn't know what technique would be the best until he's in the operation and sees what's going on under the skin.

Select a surgeon based on the quality of his results, and don't worry about the techniques he'll use on your nose. If he makes nice noses, let him use on you whatever judgment and skill allowed him to make the nice noses on the other people.

See the "Web reference" link, just below my response, for advice on how to find a good surgeon, and how to tell whether your primary surgeon should do your revision.

Steven M. Denenberg, MD
Omaha Facial Plastic Surgeon
4.8 out of 5 stars 37 reviews

suture techniques for nasal tip cartilages

It is very important to choose your surgeon, not the surgical technique, since rhinoplasty is one of the most difficult procedures to perform correctly in all  of cosmetic surgery.  Transdomal and intradomal sutures are  a specific technique that is used to narrow the nasal tip cartilages as seen in the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Consult needed

Some advice can be given if you are able to post some photos - the techniques you mention are rhinoplasty manouevres used on some but not all patients - it does sound like you will need an in-person consult with a rhinoplasty expert

Rhinoplasty maneuvers

The thing you mentioned are technical maneuvers that are performed during some operative rhinoplasty procedures. They are not performed on everyone. To determine what might be best for you, you should be seen in person.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Revision rhinoplasty

Thank you for your question. Revision rhinoplasty is a challenging surgery where often times the revision surgeon is un-doing some of the prior components of the surgery. When you look at specific techniques that might've been done during your primary rhinoplasty,y the tongue and groove technique is indicated to not only de-project the nose (bringing then nose closer to the face). Depending on where the intradermal and transdomal sutures are placed, this can cause further rotation or can change the appearance of the tip from a projection standpoint. When you look at the revision surgery moving forward, focus on what results you may want from your surgeon. Do not focus so much on the techniques that are going to be used as there are many techniques that can yield a particular result. Make sure that you consult with a double board-certified facial plastic and reconstructive surgeon. I hope this helps.

Roberto E. Garcia, MD, FACS
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Techniques used in rhinoplasty

Hi there,

Thank you for submitting the question about the specific techniques that were used in your case. 

Interdomal and transdomal sutures are sutures used in the cartilages of the nasal tip to refine and reshape the nose. Tongue in groove is a technique used to change the position of the nasal tip frequently used to deproject the nose (to make the nose less prominent on the side view).  The cartilages of the nasal tip are sutures to the septum. These specific techniques are good techniques when used appropriately. 


When considering your revision, my advice is to concentrate more on talking about the result you are looking for and less on what specific technique will be used. If your goal is to make the nose slightly longer and less upturned, speak to your doctors about how likely it is to get the result you are looking for. 


The operative report will be useful to your next surgeon. Certainly your surgeon can explain how they plan to get the result you are looking for. 


I hope this helps! 

Good luck 

Myriam Loyo, MD
Portland Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

Unsatisfactory result from rhinoplasty?

I need to see photos to give an informed answer. The terms mean nothing--its what you are left with that is important. See your surgeon if dissatisfied or get a second opinion from an experienced revision rhinoplasty surgeon.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 32 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.