Pros and Cons of Using Clinching Sutures for Nostril Reduction?

I have seen that some surgeons perform sill excisions and then use a clinching suture technique to bring the nostrils in and to reduce the width of the nasal floor. However this procedure doesn't seem to be widespread. Could you please explain the pros, if any, and cons to clinching suture in order to reduce nose width?

Doctor Answers 4

Nostril reduction - narrowing

A wide bottom base of the nose can be due to thick nostril rims, wide nostril floors - sills or a combination of the 2. If the sill is wide the usual treatment is excision of a wedge of tissue from the inner outside corner of the nostril. If the rims are wide they can be thinned by removing fat within them. Some advocate placing a suture between both out nostril rims and tightening to bring them closer together. I do not do that because there is a high risk that over time the suture will saw through the skin.

In my experience this type of sinching or tightening suture works best when used to tighten the abdominal muscles during abdominoplasty surgery. It is of intermediate value in breast lift or reduction surgery to control areola size. I have not found it to be useful in any other body area with respect to plastic surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Los Angeles Plastic Surgeon
5.0 out of 5 stars 1 review

Cinching sutures for nostril reduction.

The problem with cinching sutures for nostril reduction are many fold.  The first of which is they can always become infected and have to be removed and then the nose will revert back to its wide anatomical preoperative position.  The cinching suture also cinches the upper lip and narrows the horizontal dimension of the upper lip as well.  If the sutures should ever break or disintegrate in 20 years, the nose will revert back to its normal preoperative position.  We do not perform the cinching procedure in our practice; instead we do alar-base reductions. 

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Pros and Cons of Using Clinching Sutures for Nostril Reduction?

The cinching or clinching suture may help bring the nostrils together but it may not work for wide nasal base or flarred nostrils and recurrence and scarring are high with old techniques  For these patients I reduce the nasal ala and reposition them closer to midline without scar formation. See the before and after pictures in this page or on the website.

Mohsen Tavoussi, MD, DO
Orange County Facial Plastic Surgeon
4.6 out of 5 stars 12 reviews

Reducing nostril width

it depends entirely on the shape of your nose and what he cause is for the excess width - it could be the sill or flare, or both.  There are some aggressive techniques such as V to Y medial advancement for nostril width reduction.  Permanent sutures as you mention rarely work long-term.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 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.