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

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.

 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.