Friday, October 31, 2008
14599

Shuttle Lifting of the Nose: A Minimal Invasive Method for Nose Reshaping

K. Tunc Tiryaki, MD

Background: Suspension sutures are commonly used in numerous cosmetic surgical procedures. The use of such sutures as a part of classical rhinoplasty has been described by several authors. On the other hand, it is not uncommon to see patients seeking nasal surgery for only a minimal hump deformity combined with an under-rotated, under-projecting tip, which does not necessarily require a standard rhinoplasty. With the benefit of described suture suspension technique, this kind of nasal tip deformity can simply be reshaped via minimal incisions.

 Method: In this study, the authors described an original technique based on the philosophy of vertical suspension lifts, achieving the suspension of the nasal tip with a percutaneous purse-string suture applied through small access punctures. All was obtained under local anesthesia with a double-sided needle or shuttle, smoothly anchoring the lower lateral cartilages in a vertical direction to the glabellar periosteum excluding the skin envelope.

 Results: The technique was successfully applied under local anesthesia in carefully selected 62 patients between December 2005 and December 2007 with a follow-up changing from 8 months to 16 months. Five of the patients previously had a primary rhinoplasty operation. Outcomes were satisfactory in all but 6 cases, of which four found the result inadequate and two of them underwent a definitive rhinoplasty operation. Two patients requested the suture detached because of an over-exaggerated appearance. Operation time was very short in all patients followed by an uneventful rapid recovery.

 Conclusion: As a minimally invasive nasal reshaping procedure, shuttle lifting technique is a very good choice to achieve long-lasting satisfactory results particularly in patients with minimal hump deformity and under-rotated tip.