Four suture tip rhinoplasty: A powerful tool for controlling tip dynamics

Joseph L. Leach, Raghu S. Athré

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Objective: To evaluate the short-term effectiveness of using a 4-suture technique to control nasal tip dynamics. The 4 sutures include a medial crural suture, bilateral intradomal sutures, and an interdomal suture. Study design and setting: Retrospective photograph analysis of preoperative and postoperative photographs of 77 patients with respect to 7 dynamic variables: supratip break, projection, rotation, tip shape, tip definition, tip symmetry, and the presence of a double columellar break. Results: Seventy-four patients underwent primary rhinoplasty and had an overall average score of 5.2 on a -7 to +7 scale, with a mean follow-up period of 3.8 months. The 3 patients undergoing revision rhinoplasty had an overall average score of 5.0 and a mean follow-up of 8.7 months. Conclusion: The 4-suture technique worked best with respect to projection and tip symmetry, although the technique proved to be an effective tool overall in controlling all 7 variables mentioned above. EBM rating: C-4.

Original languageEnglish (US)
Pages (from-to)227-231
Number of pages5
JournalOtolaryngology - Head and Neck Surgery
Issue number2
StatePublished - Aug 6 2006

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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