TY - JOUR
T1 - Suture Techniques in Rhinoplasty
AU - Gruber, Ronald P.
AU - Chang, Edward
AU - Buchanan, Edward
N1 - Copyright:
Copyright 2010 Elsevier B.V., All rights reserved.
PY - 2010/4
Y1 - 2010/4
N2 - Suture techniques are an indispensable means to biologically sculpt the cartilage of the nose. Here the authors review their use in tip-plasty and present a 4-suture algorithm that allows for simple, complete control in sculpting the shape of all nasal tips in primary rhinoplasty. After a standard cephalic trim of the lateral crus leaving it 6 mm wide, one or more of the four suture techniques are applied. One of the newest techniques that has yielded excellent results is the hemi-transdomal suture, a variation of the conventional transdomal suture. This technique narrows the dome but also everts the lateral crus slightly to avoid concavities of the nostril rim. The 4-suture algorithm is useful in both the open and closed approaches. A more general use of sutures is described and referred to as the "universal horizontal mattress suture," which can be applied to remove all unwanted convexities or concavities and can be used not only to straighten the cartilage but also strengthen it. This suture has applications for the crooked septum, the collapsed lateral crus (external valve), and the collapsed internal valve, as well as for converting ear cartilage grafts into straighter, stronger grafts than previously thought possible.
AB - Suture techniques are an indispensable means to biologically sculpt the cartilage of the nose. Here the authors review their use in tip-plasty and present a 4-suture algorithm that allows for simple, complete control in sculpting the shape of all nasal tips in primary rhinoplasty. After a standard cephalic trim of the lateral crus leaving it 6 mm wide, one or more of the four suture techniques are applied. One of the newest techniques that has yielded excellent results is the hemi-transdomal suture, a variation of the conventional transdomal suture. This technique narrows the dome but also everts the lateral crus slightly to avoid concavities of the nostril rim. The 4-suture algorithm is useful in both the open and closed approaches. A more general use of sutures is described and referred to as the "universal horizontal mattress suture," which can be applied to remove all unwanted convexities or concavities and can be used not only to straighten the cartilage but also strengthen it. This suture has applications for the crooked septum, the collapsed lateral crus (external valve), and the collapsed internal valve, as well as for converting ear cartilage grafts into straighter, stronger grafts than previously thought possible.
KW - Four-suture algorithm
KW - Rhinoplasty
KW - Tipplasty
KW - Universal horizontal mattress suture
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U2 - 10.1016/j.cps.2009.12.010
DO - 10.1016/j.cps.2009.12.010
M3 - Review article
C2 - 20206741
AN - SCOPUS:77449141937
SN - 0094-1298
VL - 37
SP - 231
EP - 243
JO - Clinics in Plastic Surgery
JF - Clinics in Plastic Surgery
IS - 2
ER -