Objective Comparison of Nasal Tip Contours in the Basal View Between Dome Binding and Hemitransdomal Tip Suture Techniques in Rhinoplasty

Fernando Casanueva, Deniz Gerecci
JAMA Facial Plastic Surgery 2016 December 1, 18 (6): 481-487

Importance: The dome binding suture (DBS) used for nasal tip refinement creates the unwanted effects of nasal tip pinching owing to shadowing and loss of alar support. The hemitransdomal suture (HTS), however, refines the nasal tip while maintaining a natural contour between the nasal tip and the alar lobule. To our knowledge, no objective comparison between the DBS and HTS techniques has been described in the literature to date.

Objective: To determine whether the DBS or HTS technique results in an objectively satisfactory outcome in nasal tip contouring when assessed from the perspective of the basal view.

Design, Setting, and Participants: Postoperative basal view photographs of cosmetic rhinoplasty procedures performed on 112 Hispanic/Mestizo patients (85 [76%] women, and 27 [24%] men) in a facial plastic surgery practice in Chile, from May 2013 to May 2015 were reviewed. Only patients who underwent either DBS or HTS were included. Follow-up ranged from 6-24 months. Comparison of the nasal contour to the ideal tip-lobule line was performed and classified as satisfactory or unsatisfactory.

Main Outcomes and Measures: Satisfactory or unsatisfactory nasal tip contour in the basal view as analyzed by comparison with the ideal tip-lobule line.

Results: A total of 143 rhinoplasty procedures were performed over a 2-year period (May 2013-May 2015). A total of 112 patients met inclusion criteria. Of the 112 participants, mean (SD) age was 30 (9) years; 22 patients underwent DBS and 90 underwent HTS. Of the patients who underwent DBS, 5 of 22 (22.7%) had satisfactory contours. Of the patients who underwent HTS, 84 of 90 (93.3%) had satisfactory contours.

Conclusions and Relevance: Comparison of nasal contour in the basal view with the ideal tip-lobule line demonstrates a statistically significant improvement in the rate of satisfactory outcomes using the HTS compared with the DBS technique. This study is the first, to our knowledge, to provide objective data to support the use of this technique when performing tip contouring in rhinoplasty.

Level of Evidence: 4.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.