Suture Technique on a Bulbous Nose

Hello, how effective is a suture technique on a bulbous nose and how difficult is it to perform in order to achieve a desirable result?

Doctor Answers 3

Closed Rhinoplasty for bulbous nose

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Suture techniques are just one set of several maneuvers to address a bulbous tip.  other maneuvers include soft tissue resection between the lower lateral cartilages, in the skin flap, trimming of the lower lateral cartilages and a custom designed series of grafts for tip support and definition.  contrary to other answers to this question I feel it is very important to perform this procedure in a closed technique to preserve vascularity especially when the flap is resected and to preserve the steady state tension of the columella so that the effects of each intervention can be accurately evaluated.  dividing the columella in the 'open technique' also leads to delayed healing and prolonged swelling which can be very frustrating.  I hope this helps!

All the best,

Rian A. Maercks M.D.

Treatment of the bulbous nose

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Sorry to say this but there is no correct way to answer your question the way it is worded. As surgeons we plan rhinoplasty surgery to make adjustments to the cartilage and bone structure under the nasal skin. Based on experience we expect certain changes on the appearance of the nose from these surgical maneuvers. However the appearance or final result is highly dependent on the way the skin redrapes over and adapts to these changes in the cartilage and bone. If the skin and fat layers are very thick the effect of the cartilage/bone manuevers is diminished. Sadly we cannot just be more aggressive in these patients because that will creatmore  problems rather than achieve the desired look. In those patients with thinner skin and fat layers of the nose the suture techniques are very effective.

In patients who have rhinophymas the skin and fat layers are quite thick. In these patients the treatment is surgery on the skin fat layer only without any surgery on the bone are cartilage.

Without a photo or face to face examination I cannot say which applies to you specifically.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Suture Technique on a Bulbous Nose

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Suture technique is an important part of tip refinement in majority of noses particularly bulbous tip. The bulbous rhinoplasty needs to be performed through an open technique which allowes suturing as well as grafting to be done easily.

Mohsen Tavoussi, MD, DO
Orange County Facial Plastic Surgeon

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.