See a real life example of how dome binding sutures can be used during rhinoplasty to refine the bulbous nose.

Last time I discussed how suture-based dome binding sutures can be used to both define the nasal tip and flatten a bulbous nasal tip. As promised, today we'll go over a few intra-operative photos that show how dome binding sutures work in real life.
 

Intra-operative Rhinoplasty Case Study Photos

Let's start with this base view photo of a nose with a bulbous tip:

You can see how the lower lateral cartilage are quite bowed, or convex with an ill-defined domal area.

Placing the Dome Binding Sutures

Our next step is to use a permanent suture to grab a portion of the dome cartilage.

Next, we continue with another bite of the cartilage in a different portion of the dome:

Lastly, the suture is knotted around the dome creating a cinching action:

You can see  how this binding action creates a sharper, more defined tip and a flatter lower lateral cartilage.

Dome binding suture before and after

So now that we've seen how dome binding suture placement works let's see what's important -- the end result. This photo shows a frontal view of this patient before and 13 months after her rhinoplasty surgery.

This additional view shows her results from an oblique angle.

A very natural appearing, yet refined nose has resulted in part from the dome binding sutures that were placed. More than dome binding sutures went into this patient's rhinoplasty, though. You can see how else I made her large nasal tip smaller here.