How does a rhinoplasty surgeon use sutures to lift the tip of the nose?

Question

Can the tip of the nose be lifted with internal sutures, or is it necessary for the needle to pass through the outer layers of nasal skin? I am concerned about bizarre scarring and/or threads hanging from the tip of my nose. Thank you.

Thomas A. Mustoe, MD, FACS · Answer

Lifting the tip of the nose is a standard part of rhinoplasty and does not involve external sutures. A variety of maneuvers will result in lifting the tip, but most frequently the procedure involves removing some of the distal septal cartilage (shortening it), often with removal of some soft tissue and mucosa as well. Sutures are part of the repair, but are all internal.

Michael A. Epstein, MD, FACS · Answer

Thank you for your question.Lifting, or "rotating" the tip of the nose is a common maneuver in rhinoplasty involving manipulation of the cartilage and internal suturing.  All of the suturing is internal, so you shouldn't have any bizarre scars or threads at the end.  I recommend consulting with an experienced rhinoplasty surgeon who can explain the procedure in more detail based on your nose shape.  Some surgeons also have computer simulation to allow you to "see" your new nose, which is a helpful communication tool between the doctor and patient (we have the Vectra at our office).  Best of luck!Cheers,Dr. Michael EpsteinMAE Plastic SurgeryNorthbrook, IL

Barry L. Eppley, MD, DMD · Answer

Reshaping of the nasal tip cartilages is done through the placement of internal sutures, usually through an open rhinoplasty method.

Steven Wallach, MD · Answer

Tip elevation can occur as a result of a number of maneuvers using various suturing techniques as well as manipulating or trimming cartilage.  Best of luck.

William Portuese, MD · Answer

Suture techniques were usually used to reduce the bulbous nasal tip.  Lifting the tip can also be accomplished with a variety of maneuvers during the rhinoplasty procedure without sutures.  For more information and many examples, please see the link and the video below

Robert J. Paresi Jr., MD, MPH · Answer

Thanks for the question.  Internal sutures are typically not used to raise the nasal tip but they are often used to reshape the underlying cartilage framework resulting in a raised nasal tip.  Internal sutures can also be used to correct asymmetries of the cartilaginous framework.  All of these sutures are usually internal and due not penetrate the outer layers of the nasal skin.  If an open rhinoplasty was done, the sutures may be in the transcolumellar incision or the internal mucosal lining which had an incision at the time of the rhinoplasty.  Whatever the reason for the sutures, abnormal scarring of the skin is a rare complication of rhinoplasties.  I recommend seeking a consultation with a board-certified plastic surgeon with experience in performing rhinoplasties.

Robert S. Schmidt, MD · Answer

Thanks for your question. There are several ways of raising (the technical term is "rotating") a nasal tip. The most common way in my practice is to excise a small amount of cartilage from the upper side of the cartilages the make up the nasal tip. For extremely droopy tips, the cartilage can be cut and telescoped on itself to raise a tip. Suture techniques usually will narrow a tip and may raise it a small amount. However, the sutures NEVER go through the nasal skin so you don't need to worry about scarring or threads from these techniques. Hope this helps.

Fred J. Bressler, MD, FACS · Answer

Tip definition and support can be achieved in numerous ways with suture modifications and cartilage grafts, along with other techniques. For example a droopy nasal tip can be "lifted" with a cartilage strut graft and suture technique called the Lateral Crural Steal. Other suture modifications work very well and yield predictable, attractive results via an open approach. Fortunately, these techniques involve internal sutures and nothing is visible or passing through the outer layers of your skin.

Jay M. Pensler, MD - Account Suspended · Answer

I commonly utilize sutures to fix the position of the cartilage in rhinoplasty.The sutures are placed so they are internal and do not go through he skin.

How does a rhinoplasty surgeon use sutures to lift the tip of the nose?

Answers (9)

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