Journal archive · Nasal tip · Open versus closed approach · 2009
Endonasal suture techniques in tip rhinoplasty
Perkins S, Patel A.
In the archive as a landmark paper: the core sweep runs 2011–2026, and this one is here because the history of rhinoplasty rests on it · cited on tip sutures.
From the abstract
“Suture modification techniques have long served as reliable methods to surgically improve nasal tip contour by allowing control of width, projection, and rotation during rhinoplasty. Tip abnormalities characterized by a wide or broad shape are particularly amenable to such techniques. In the senior author's hands…”
Excerpt; the full abstract is on PubMed.
Citation
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What the rhinoplasty literature says on this paper's topics, cited line by line to PubMed.
Nasal tip
Tip surgery is now a support problem rather than a sculpting problem: the septal extension graft holds projection and rotation where the columellar strut loses them (0.2% against 4.7% projection loss at one year), and the current series repair, reposition and reinforce the lower lateral cartilages instead of excising them.
Open versus closed approach
Whether the surgeon opens the nose through a small incision across the columella or works entirely through the nostrils has been argued in print since 1973, was put on facing pages of Plastic and Reconstructive Surgery by Jack Gunter and Jack Sheen in 1997, and was finally pooled in 2025: across twenty studies and 1,067 patients there is no significant difference in what patients report, in breathing, in complications or in swelling.
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- Arch FPS Effect of midfacial asymmetry on nasal axis deviation: indications for use of the subalar graftYao F, Lawson W, Westreich RW2009PMID 19451449Abstract
- APS The hemitransdomal suture for narrowing the nasal tipDosanjh AS, Hsu C, Gruber RP2010PMID 20489397Abstract
- PRS Preventing alar retraction by preservation of the lateral crusGruber RP, Zang A, Mohebali K2010PMID 20375762Abstract
- ASJ Suture techniques for the nasal tipGruber RP, Weintraub J, Pomerantz J2008PMID 19083512Abstract