title: Introducing a Favourite Tip Definition and Projection with Tripod Suture in Rhinoplasty.
abstract: BACKGROUND
  Surgical manipulation of the lower lateral cartilages of nasal tip could cause subtle but significant responses to the manipulation. The suture-techniques almost always offer a reliable and dramatic method of tip reshaping without a need to break or interrupt the alar rim strip or even adding tip graft.
  
  
  OBJECTIVE
  The aim of this study was to describe and assess outcomes of a new suture technique in rhinoplasty by using cephalic dome septal rotation suture for better tip definition.
  
  
  METHODS
  All consecutive women (62 women) who attended our centre with nasal tip drooping and some degree of columellar retraction, underwent this technique from January 2005 to September 2009. Their ages ranged from 17 to 32 years old. Fifty one primary open and 11 secondary open rhinoplasties were performed using the conventional techniques and then the new suture technique was applied before closing the incisions on each patient.
  
  
  RESULTS
  The patients were followed-up from 22 to 72 months (mean = 52.3). The projection and rotation was satisfactory in all patients and the final results persisted with only minimal changes over time.
  
  
  CONCLUSIONS
  It is important to say that this new suture is different from 'tip rotation suture' that was described by Tebbets. Our suture maintains the favorite tip definition with slight dorsal tip inclination. Indeed, it causes a two-point definition as the columellar lobular angle and the supra tip break definition. In addition, long-term follow-up has shown that this new suture (i.e., cephalic dome-septal rotation suture) is able to maintain optimal position of the nasal tip projection and definition.
authors.affiliation: Professor of Plastic Surgery, Department of Plastic Surgery, 15 Khordad Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences , Tehran, Iran .
authors.forename: Sadrollah
authors.initials: S
authors.lastname: Motamed
authors.affiliation: Associate Professor of General Surgery, Iran University of Medical Sciences & Resident of Plastic and Reconstructive Surgery, Department of Plastic Surgery, 15 Khordad Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences , Tehran, Iran .
authors.forename: Hamidreza Alizadeh
authors.initials: HA
authors.lastname: Otaghvar
authors.affiliation: Assistant Professor of Plastic Surgery, Department of Plastic Surgery, Shahid Modares Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences , Tehran, Iran .
authors.forename: Feizollah
authors.initials: F
authors.lastname: Niazi
authors.affiliation: Associate Professor of Plastic Surgery, Department of Plastic Surgery, 15 Khordad Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences , Tehran, Iran .
authors.forename: Seyed Mehdi
authors.initials: SM
authors.lastname: Moosavizadeh
authors.affiliation: Resident of Plastic and Reconstr Uctive Surgeon, Department of Plastic Surgery, 15 Khordad Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences , Tehran, Iran .
authors.forename: Babak
authors.initials: B
authors.lastname: Motaghedi
authors.affiliation: Resident of General Surgery, Rasool-E-Akram Educational Hospital, Iran University of Medical Sciences , Tehran, Iran .
authors.forename: Adnan
authors.initials: A
authors.lastname: Tizmaghz
keywords: Alar Cartilage; Reconstruction-Outcome; Tripod suture