rhinonightmare

Ok I don't know how many of you know this but when a plastic surgeon narrows your tip what they do is cut the two domes and re-attach them back together closer. The domes are each side of your nose tip. Yeah so they separate the domes, cut some out, and stitch or suture it back together. I saw a doctor for a closed rhinoplasty consultation and he's one of the best and he said that with open rhinoplasty where they cut and sew the two dome heads closer together, it is like sewing two springs together. That it will work for a while but over time they begin to come apart and years later you end up with a funny looking nasal tip which is wider than it was after surgery.

My question is if that's how you narrow that domes and that's what's going to happen then what method can you do to prevent this? Does it maybe depend on the method of stitching they do? Maybe the type of thread they use? And how long does this thread last with 100% strength. Because what if you have this done when you're 20 and then 50 years later the thread is eroded away and everything.

Any clarification on this would be cool.

obama08

Thats a good questio n I never even thought of that. do you think they use like a wire type or some kind of synthetic thread like fishing line? You're right though any kind of stitching inside the nose must deteriorate over time since it's always wet in there and the body is constantly removing and cleaning foreign substances from your system.

versace

Surgeons should discuss this more with patients. Although this plastic surgery message board is an excellent resource, I feel doctors need to be more transparent to patients about what rhinoplasty involves.

In rhinoplasty typically a 5-0 clear polypropylene (Prolene) suture is placed horizontally through the lateral and medial crura of the two nasal domes. Changing the tension of the suture is what determines how much narrowing there will be. Dome cartilage must be carefully manipulate because it's not simply "the harder you pull, the narrower it is" as there's a fine line between the how much you can narrow the dome cartilage and how much pulling creates tip deformities later on. Bulbous tip noses, especially more common in ethnic rhinoplasty, are much more difficult to narrow to the ideal size. Double dome tip cosmetic work usually involves the single dome mattress suture or the double dome mattress suture techniques. After the final results can be seen (1 to 3 years post-op) the ideal nose tip should be symmetrical, have dome definition, and a slight supratip break.

__________________
“One popular new plastic surgery technique is called lip grafting, or "fat recycling" wherein fat cells are removed from one part of your body that is too large, such as your buttocks, and injected into your lips; people will then be literally kissing ass.”

rhinonightmare

Thanks but so does this Prolene stuff last forever in your nose after rhinoplasty then?

versace

Yes Prolene is permanent. In rhinoplasty and revision rhinoplasty the surgeon will usually use either 4.0 or 5.0 or 6.0 Prolene sutures, which are different kinds of the stitching.

__________________
“One popular new plastic surgery technique is called lip grafting, or "fat recycling" wherein fat cells are removed from one part of your body that is too large, such as your buttocks, and injected into your lips; people will then be literally kissing ass.”

rhinonightmare

Wait I did some research on this Prolene and this is what I found

-Made by Johnson and Johnson
-Pigmented blue
-Nonabsorbable
-Like nylon
-Comes in sizes 4.0 to 7.0

But I couldn't find does this stuff ever break? Let's say you had your nose tip narrowed and the domes sewn together with this Prolene or nylon and the thread later broke. Would the domes goes back to how they were before rhinoplasty? Is this what happens when peoples nose tips go back to being wide after they've had surgery? Have you ever heard of someone having to get revision rhinoplasty to fix Prolene that breaks?

A lot of questions but doctors never mention this stuff!

versace

I havebn't heard of any cases where Prolene broke, but the quality of the stitch does determine how it will hold up. Think of it as making a knot in a rope; you can do it properly or you can do it improperly where it falls apart after a while. Same thing with Prolene suturing. A new trend with it is putting an extra stitch with the "double dome stitch" to ensure it holds up longer.

__________________
“One popular new plastic surgery technique is called lip grafting, or "fat recycling" wherein fat cells are removed from one part of your body that is too large, such as your buttocks, and injected into your lips; people will then be literally kissing ass.”