A Useful Tool for Various Problems in Nasal Tip: The Cephalic Transdomal Suture : Journal of Craniofacial Surgery

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A Useful Tool for Various Problems in Nasal Tip: The Cephalic Transdomal Suture

Bilkay, Ufuk MD*; Biçer, Ahmet MD*; Erçin, Burak Sercan MD†; Durukan, Kutay MD*; Özek, Zeyyat Cüneyt MD*; Gürler, Tahir MD*

Author Information

*Department of Plastic, Reconstructive, and Aesthetic Surgery, Faculty of Medicine, Ege University, Izmir, Turkey

†Department of Plastic, Reconstructive, and Aesthetic Surgery, Medical Park Pendik Hospital, Pendik, Istanbul

Address correspondence and reprint requests to Ahmet Bic¸er, MD, Department of Plastic, Reconstructive, and Aesthetic Surgery, Faculty of Medicine, Ege University, Ankara Caddesi No 1, 35100, Izmir, Turkey; E-mail: [email protected]

Human rights statements and informed consent: All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and its later amendments. Informed consent was obtained from all patients for being included in the study. Furthermore, all patients signed consent for publication of their photography.

The authors report no conflicts of interest.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jcraniofacialsurgery.com).

The Journal of Craniofacial Surgery 33(7):p 1945-1949, October 2022. | DOI: 10.1097/SCS.0000000000008409

Abstract

Surgical manipulation of the nasal tip is a critical point in functional and aesthetic rhinoplasty procedure. Cephalic strip excision from the lower lateral cartilages, elongation or shortening the caudal septum, structural grafting for supporting the medial and lateral crura are major structural moves in building a durable cartilaginous framework. However, it is suture techniques that make up the final touch in fine tuning of the shape, projection, definition, and angulation (rotation) of the nasal tip over this framework.

Problems with fine-tuning of the nasal tip include inadequate or excessive definition, or projection resulting with bulbous or boxy appearance can be overcome reversibly with correctly placed sutures. One of the most decisive sutures in this context is transdomal sutures. Incorrect placement of which can result with too narrow or too wide nostril apices, as well as a cephalic malposition deformity of the lower lateral cartilages, botching an otherwise perfectly executed rhinoplasty procedure.

In this article, cephalad placement of the transdomal sutures, and its relevance is disclosed in 223 consecutive cases of primary rhinoplasty.

Copyright © 2022 by Mutaz B. Habal, MD

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