Is it possible to trim the dome during dome suturing?

I have large LLCs & was considering having a medial crural fixation suture, a cephalic trim, then a interdomal suture to correct my bulbous tip. Even more important to me than that is that from where the bone ends, my domes stick out too far and start to curve down ... I think its my a large nostril/ LLC spread that is causing this. It goes up, and my tip sinks down. Is there a way to just trim off that area, or would that mess up my septum?

Doctor Answers 6

Rhinoplasty for the bulbous tip

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Without  a full set of pictures, it is impossible to give an opinion. The bulbous tip  is addressed with interdomal and intra-domal suture techniques to the lower lateral cartilage. In addition some patients require conservative cartilage removal also known as a cephalic trim. These techniques can be performed with closed rhinoplasty. Look for a very experienced rhinoplasty surgeon for best results. For many examples, please see  the link below

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Is it possible to trim the dome during dome suturing?

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The short answer is YES, if that is the appropriate maneuver to perform for you. The problem with describing rhinoplasty techniques is that the procedure involves reducing and shaping three dimensional cartilage and bone as opposed to carving a solid block of material. With regard to what would work best for you, it's impossible to say without an in-person evaluation. From a technique standpoint, the maneuvers you mention can be, and are, frequently performed together.

Stephen Weber MD, FACS
Denver Facial Plastic Surgeon

Is it possible to trim the dome during dome suturing?

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     I would leave the technical aspects to the surgeon you select, because there are several ways to address any one issue.  The manner in which these procedures are executed is far more important.  Pictures or an exam would be necessary to provide an evaluation of what would be right for you.

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

Nasal surgery technique?

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Keep in mind, that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do without having photos and without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the proposed operative procedure may not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or facial plastic surgeon (otolaryngologist) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 22 reviews


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I would find a board certified PS in your area and have him take your photos and then alter them digitally until, with your input, you see the result that you would like to see on your face after surgery.  Assuming that result is realistic, then have him explain to you how he would accomplish it so you are fully informed as to what can and what cannot be accomplished.  Without a full examination it is otherwise impossible to answer your question.

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

Rhinoplasty Questions requiring photographs

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Dear Chrmdy, Some photographs of your nose would be very helpful in determining your possible surgical needs. The best advice is to have some consultations with expert rhinoplasty surgeons.  Under direct examination a surgeon will then advise you of exactly what needs to be done surgically to attain the desired results you discuss above. Using digital imaging will also help you see the proposed changes prior to your procedure making sure you and the surgeon on on the same page. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 reviews

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.