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
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.
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.
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.
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.
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.