Goals This study investigates the universal applicability of the mattress suture to change and control the curvature of a wide variety of nasal cartilages and grafts. Methods Cartilage was harvested from cadavers to test the curvature control of a mattress suture and resultant strength of the specimen. The ideal spacing for the mattress suture and the consequent change in stiffness of the cartilage was measured. The mattress suture was then applied to a wide variety of clinical situations. Results Cadaver studies indicated that there is an ideal mattress spacing (6-8mm for ˝mm specimens and 8-10mm for 1˝ mm specimens) that will remove most curvature and provide stability. The mattress suture was found to increase the stiffness and strength above normal. Clinically the mattress suture is universally applicable to a variety of situations: from warped grafts and struts to nasal tip bulbosity. 29 cases were studied over a period of 10-23 months. Curvature control was obtained in all cases with partial recurrence in only two cases. Conclusions The mattress suture is an effective means of achieving control of the curvature of cartilages of the nose and results in increased strength. The mattress suture reduces the need for scoring and cartilage grafting.