Aesthetic Plastic Surgery

, Volume 31, Issue 2, pp 174–178 | Cite as

Effect of Nasal Tip Surgery on Asian Noses Using the Transdomal Suture Technique

  • Tae-Young Jang
  • Yoon-Seok Choi
  • Yoon-Gun Jung
  • Kyung-Tae Kim
  • Kyu-Sung Kim
  • Jung-Seok Choi


The past two decades have ushered in a new era of nasal tip surgery. The new philosophy focuses on preserving and reorienting nasal tip structures. Modern suture techniques can give predictable results because of more precise suture placement. Only a few reports, however, have objectively evaluated the suture techniques for Asians. Accordingly, the authors aimed to assess the efficacy of the tip suture technique through projection and rotation analysis. We focused on transdomal sutures because they involve one of the most popular suture techniques. Preoperative and postoperative photographs of 85 patients who underwent rhinoplasty at Inha University Hospital between June 2002 and June 2004 were analyzed. The patients were categorized into four groups according to the techniques used. Tip projection was measured by the modified Heuzinger’s method and tip rotation by the nasolabial angle. The pre- and postoperative indexes were compared within each group and among the four groups. Paired and unpaired t tests were used for statistical analysis. When the pre- and postoperative indexes were compared within each group, only the combined technique (transdomal suture with onlay graft) showed significant tip projection improvement. All tip surgeries resulted in insignificant tip rotation increase. Comparison among the four groups showed no significant difference based on the type of tip surgery performed. The suture technique has many advantages, although it has some limitations with Asian noses, especially if used alone. Therefore, we recommend using the suture technique in combination with other tip surgical procedures, such as onlay grafts, to achieve significant tip projection.


Rhinoplasty Tip surgery Transdomal suture 



This research is supported by Inha University Research Grant.


  1. 1.
    Adamson PA, Tropper GJ, McGraw BL: Otoplasty. In: Krause CJ (ed) Aesthetic facial surgery. Lippincort: Philadelphia, 1991Google Scholar
  2. 2.
    Crumley RL, Lancer M: Quantitative analysis of nasal tip projection. Laryngoscope 98:202, 1988PubMedGoogle Scholar
  3. 3.
    Furnas DW: Correction of prominent ears by conchomastoid sutures. Plast Surg 42:189, 1968Google Scholar
  4. 4.
    Goldman IB: The importance of medial crura in nasal tip reconstruction. Arch Otolaryngol 65:143, 1957Google Scholar
  5. 5.
    Guyuron B: Footplate of the medial crura. Plast Reconstr Surg 101:1359, 1998PubMedCrossRefGoogle Scholar
  6. 6.
    Huizing EH: Functional reconstructive nasal surgery. Thieme Medical Publishers, Germany, 2003Google Scholar
  7. 7.
    Johnson CM, Toriumi DM: Open structure rhinoplasty. WB Saunders: Philadelphia, 1990Google Scholar
  8. 8.
    Joseph J: Nasenplastick und sonstige Gesichtsplastick nebst einen Anhan ueber Mammaplastick. Verlag von Curt Kabitzsch: Leipzig, 1931Google Scholar
  9. 9.
    McCullough EG, English JL: A new twist in nasal tip surgery: Alternative to the Goldman tip for the wide or bulbous lobule. Arch Otolaryngol 111:524, 1985Google Scholar
  10. 10.
    Mustard JC: The correction of prominent ears using simple mattress sutures. Br J Plast Surg 16:170, 1963CrossRefGoogle Scholar
  11. 11.
    Rich JS, Friedman WH, Pearlman SJ: The effect of lower cartilage excision of nasal tip projection. Arch Otolaryngol Head Neck Surg 117:56–59, 1991PubMedGoogle Scholar
  12. 12.
    Rohrich RJ, Adams WP Jr: The boxy nasal tip: Classification and management based on alar cartilage suturing techniques. Plast Reconstr Surg 107:1849–1863, 2001PubMedCrossRefGoogle Scholar
  13. 13.
    Tardy ME, Cheng E: Transdomal suture refinement of the nasal tip. Facial Plast Surg 4:317, 1987CrossRefGoogle Scholar
  14. 14.
    Tardy ME, Bradford SP, Margaret AW: Transdomal suture refinement of the nasal tip: Long-term outcomes. Facial Plastic Surg 9:275–284, 1993Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Tae-Young Jang
    • 1
  • Yoon-Seok Choi
    • 1
  • Yoon-Gun Jung
    • 1
  • Kyung-Tae Kim
    • 1
  • Kyu-Sung Kim
    • 1
  • Jung-Seok Choi
    • 1
  1. 1.Department of Otolaryngology-Head and Neck SurgeryInha University College of Medicine, IncheonJung-GuKorea

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