Does dome-binding suture elevate the tip?

If a patient is performed dome-binding suture, does she/he also get a slight tip rotation as a result? I have a bit of a droopy, bulbous tip, and I was wondering if only dome-binding sutures were performed would it be fine.

Doctor Answers 6

Does dome-binding suture elevate the tip?

    This all depends upon the placement of the sutures and the anatomy. 

Kenneth Hughes, MD

Los Angeles, CA

Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Tip platy/ procedure dome binding sutures do elevate the tip

Suture techniques to the nasal tip cartilages can rotate the tip and give added projection. These are also  known as  dome binding sutures (Inter-domal and intra-domal sutures)  Dome binding sutures can be performed as a stand-alone procedure( tip plasty) or a full rhinoplasty can be performed.

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

Dome Suturing and Nasal Tip Elevation

The simple answer is that dome suturing can or cannot elevate the tip. There are different types of dome suturing and how they are done can influence what changes are seen besides tip narrowing. Other maneuvers, such as caudal septal resection and cephalic trim of the lower alar cartilage also have an important role in tip elevation as well.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Dome binding sutures for tip elevation

There are many suturing techniques available to contour and change the shape of the tip cartilages. Most techniques cause a combination of maneuvers to the tip (ex. elevation and rotation). Dome suturing usually causes a small and conservation elevation and rotation. The amount of rotation may not be adequate with dome suturing alone for a droopy, bulbous tip. Consult with a well-trained rhinoplasty surgeon who has the experience to determine which maneuver is best-suited for the degree of change you need.

Kristina Tansavatdi, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 33 reviews

Dome Sutures to Rotate the Nasal Tip

Dome sutures can rotate the nasal tip if the lateral part of the cartilage is incorporated into the suture. This is called a lateral crural steal. The more of the lateral crus recruited into the suture, the more rotation you will generally have. 

It it is important to note that there are a variety of ways to achieve tip rotation. There is no right or wrong way, it is all about what would work best for your nose. That is the art of rhinoplasty.  Choose a surgeon who is skilled at rhinoplasty and commonly performs this operation. 

Jacob D. Steiger, MD
Boca Raton Facial Plastic Surgeon
5.0 out of 5 stars 62 reviews

Dome binding sutures in rhinoplasty

Depending on the anatomy of an individual's nasal cartilages, it might be possible to put in dome-binding (also known as interdomal) sutures in such a way to get elevation of the tip also.  Most of the time however, other trick and techniques are needed to truly accomplish this.

Reza Momeni, MD FACS
Summit Plastic Surgeon
5.0 out of 5 stars 44 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.