The bulbous tip can be refined with intradomal and interdomal sutures. This is reversible.Find a board certified plastic surgeon who performs hundreds of rhinoplasties and rhinoplasty revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA

Sutures will be used in rhinoplasty particularly on the tip to shape the cartilages of the nose. Interdomal sutures will suture the cartilages on the left and right side of the tip of the nose together. As this suture is tightened it will pull the sides of the tip of the nose together. This way the tip can be narrowed and a bulbous tip made more refined.I hope that helps explain one of the manoeuvres we use in rhinoplastyJeremy Hunt

There are several maneuvers for narrowing a bulbous boxy tip. These involve cephalic trim ( cutting away part of the cartilage) tip sutures: intradomal (within one side of the tip) Interdomal/transdomal (from one side to the the other) and cartilage grafts. As far as tip sutures, they are employed in almost every rhiniplasty but in different degrees. Just like anything too much is not good nor is too little, there is no textbook answer the degree of suturing is an aesthetic judgement. Initially tip suturing can be released, but once the nose heals it ould have to be camofolaged with a graft.

Hello. The nasal tip is compromised of two domes. In the bulbous nose, sutures may be used to reshape the domes and narrow the tip. Intradomal sutures refer to sutures within each individual dome. Interdomal sutures refer to sutures between the two domes. Generally speaking, suture techniques are reversible. I hope this is helpful. Regards, Anand G. Shah, MD.