Evaluating the Effectiveness of the Lateral Intercrural Suture to Decrease the Interdomal Distance to Improve the Definition of the Nasal Tip in Primary Rhinoplasty

Abstract

Introduction Several surgical techniques emphasizing sutures on the lower lateral cartilage have been studied by surgeons as instruments to improve nasal tip remodeling. It is already known that the domal divergence angle and its definition angle can be modified by lateral intercrural suture (LIS). Techniques for measuring these structures are not yet standardized. Objectives Assess the efficacy of LIS using polydioxanone 4–0 absorbable thread by interdomal distance and systematize the LIS technique to improve nasal tip definition. Materials and Methods This prospective study measured and analyzed interdomal distances measured preoperatively and perioperatively compared with 3- and 6-month postoperative measurements. Results LIS was efficient on reducing interdomal distances. Conclusion LIS is statistically safe and efficient and has low morbidity when utilized in patients with mild to moderate deformities, because it reduces the domal divergence angle, effectively sustaining the nasal tip.

Interdomal Suture: Maintaining Nasal Tip Projection With East–West Advancement Flap Repairs

“…The IDS should be used cautiously in patients with narrow nares or a small alar base (less than 30° of angle of domal divergence). 4 The use of an IDS in these patients can cause narrowing of the nasal valves and theoretically may result in airway obstruction. The authors prefer 4-0 or 5-0 braided polyglactin 910 suture to prevent pull through and shearing of the nasal cartilage.…”

Technical and Clinical Considerations for Facial Feminization Surgery With Rhinoplasty and Related Procedures

“…Tip reshaping is one of the key points in feminization rhinoplasty, and to provide long-term stability, grafts, such as a caudal extension graft in combination with a tongue-in-groove maneuver, shields, or on-lay grafts on top, are essential . Suturing the medial and lateral crura (intradomal sutures and interdomal sutures) is important to create an attractive nose projection, refinement, and rotation …”

“…[15][16][17][18] Suturing the medial and lateral crura (intradomal sutures and interdomal sutures) is important to create an attractive nose projection, refinement, and rotation. [19][20][21][22] Feminization of the Profile | Any excess bridge composed of bone and cartilage is removed to lower the profile for an optimal result. If the amount of the hump to be resected is less than 2…”