title: Four suture tip rhinoplasty: a powerful tool for controlling tip dynamics.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  C-4.
authors.affiliation: Department of Otolaryngology, University of Texas Southwestern Medical School, Dallas, TX, USA.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Leach
authors.forename: Raghu S
authors.initials: RS
authors.lastname: Athré
mesh_terms: D006801:Humans; D009300:Nasal Septum / Q000601:surgery*; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D013536:Suture Techniques