Can nose tip lift be done with permanent sutures without cutting anything off? (Photo)

Question

I've had 2 rhinoplastys done and the result is OK, but I have a visible dent on the right side and a hanging columela, especially when I smile. I can feel the bottom of the septum cartlige sticking out, pushing my nose down. I think that part could be trimmed but the main issue is the tip dent and lack of support on the top... I'm wondering if there is a way to lift and reshape the tip with sutures only that would be least invasive, but also permanent? Thank you for your time and responses.

Myriam Loyo, MD · Answer

Hi there, you have very good questions. Suture can be used during rhinoplasty to change the shape of the nasal cartilages and allow them to heal in a new shape and position. Sutures are a tool we use during surgery to reshape the nose.  Slightly trimming or cutting cartilage is another surgical technique used for the same purpose of reshaping the nose.  It is possible that sutures are enough to achieve a desired shape. In order to be able to suture cartilages and allow them to reshape into the position we want, we often need to dissect and free the cartilages from the attachments to the skin, nasal mucosa and other cartilage and bone so that then can move more freely. In your questions, it seems like you like how lifted your nose is at rest, but feel like the nasal tip and columella droop down when you smile. Which makes me think you want the nose to remain at its current position at rest, but to avoid having it droop when you smile. To fully understand why the nasal tip is drooping and if the front of the septum is contributing, and exam in person with a rhinoplasty surgeon is the best way to go. It is possible the caudal septum be slightly trimmed and the muscle pulling the nose down separated. Afterwards, suture is used to secure the cartilages in the new position. Sometimes a small dose of botox (1-2 units) in the muscle that pulls the nose down can help prevent the nasal tip droop.Hope this information is helpful. Think carefully about our options before embarking on a third nasal surgery.

William Portuese, MD · Answer

Sutures placed in the nasal tip accomplish narrowing the bulbous tip which does not appear to be necessary according to the limited photographs. Suture techniques involve either open rhinoplasty, or a closed rhinoplasty with a full delivery of cartilages to accomplish this. This procedures performed general anesthesia as an outpatient procedure monitored by physician anesthesiologist in a surgery center. In our practice we use dissolvable stitches that take 4 to 6 months in order to dissolve. We stopped using permanent stitches due to stitch abscesses. Study your prospective surgeon's before and after photo gallery and make sure that it is extensive if you go on with a third  Rhinoplasty procedure.

Can nose tip lift be done with permanent sutures without cutting anything off? (Photo)

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Can nose tip lift be done with permanent sutures without cutting anything off? (Photo)

Answers (2)

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Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.