Suture correction of nasal tip cartilage concavities

This paper describes a suture technique to correct nasal tip cartilage concavities. Exposure is through an open rhinoplasty or cartilage delivery technique. The concave cartilage is tented upward from inside the nose to the desired contour. Interlocking mattress sutures are then inserted in a chain-link fashion to hold the cartilage in position. Each stitch creates a miniature convexity, and the combined linkages form the complete convex arch. Three tension-control sutures are usually required. The technique was applied in 15 patients with alar cartilage concavities. Four types of cartilage involvement are described: the lateral crus and lateral dome (2 patients), the lateral crus alone (5 patients), the medial dome region (2 patients), and the lateral dome region (6 patients). Two case examples are presented. There has been no loss of correction in follow-up examinations ranging from 9 to 26 months.