Aesthetic Plastic Surgery

, Volume 38, Issue 4, pp 653–661 | Cite as

Closed Rhinoplasty with Open Approach Advantages: Extended Intranasal Incisions and Tip Rearrangement Sutures

  • Haldun Onuralp KamburoğluEmail author
  • Aycan Uğur Kayıkçıoğlu
Innovative Techniques Aesthetic



Two main well-known approaches are used in rhinoplasty: open and closed techniques. This study aimed to define two new tip suture modifications that enhance and stabilize tip shape, projection, and position through an extended infracartilaginous incision with an open rhinoplasty exposure.


This study investigated 56 consecutive primary rhinoplasty patients 18–51 years of age (mean age 27.8 years) who underwent surgery between June 2011 and June 2012 and had at least a 1-year postoperative follow-up period. Rhinoplasty was performed through an extended infracartilaginous incision with an open exposure. Transdomal suture modification for columella-lobular angle augmentation and a footplate repositioning suture for tip projection (and position) enhancement also were defined. A postoperative satisfaction survey was applied to all the patients at their 1-year follow-up visit.


The postoperative satisfaction rate was 96 %. The nasal tip positions and projections of the patients were fine and stable in all the patients after a 1-year postoperative period. At this writing, no over- or underprojection, supratip deformity, saddle-nose deformity, or dorsal-surface irregularities have been encountered. Representative cases are displayed.


This study defined two new tip suture techniques and combined them with an extended infracartilaginous incision. Also, control of the entire nose and nasal valve area was possible through this incision.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors


Rhinoplasty Tip suture Tip position Tip rotation Infracartilaginous incision 



None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.

Conflict of interest

There is no conflict of interest between the authors.

Supplementary material

Video 1

Demonstration of the dissection technique. (WMV 13538 kb)

Video 2

Demonstration of the modified transdomal suture. (WMV 13397 kb)

Video 3

Demonstration of the footplate repositioning suture. (WMV 4357 kb)


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Copyright information

© Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2014

Authors and Affiliations

  • Haldun Onuralp Kamburoğlu
    • 1
    Email author
  • Aycan Uğur Kayıkçıoğlu
    • 1
  1. 1.Department of Plastic, Reconstructive, and Aesthetic SurgeryHacettepe University Faculty of MedicineAnkaraTurkey

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