Abstract

Based on a 25-year experience, the author considers open tip suture techniques to be the best method of achieving consistent and reproducible tip changes that can please patients with a wide variety of tip deformities. The described technique consists of selecting the ideal combination of the following six sutures: (1) columellar strut and suture, (2) domal creation, (3) interdomal, (4) domal equalization, (5) tip position, and (6) lateral crural convexity. If additional definition is required, then tip refinement grafts can be added to accommodate thicker skin or lateral crura abnormalities.

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