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Title:Domes Technique for Nasal Tip Rotation in Rhinoplasty

The domes technique allows facial plastic and other surgeons to more precisely predict and control the desired rotation angle of the nasal tip in patients undergoing primary rhinoplasty.

This procedure video illustrates the technique with the following steps:

The nose is marked for the desired position of the tip, and pre- and post-cartilaginous incisions are made.

The delivery approach is used to expose the alar cartilages. The domes are marked. A conservative resection of the cephalic portion of the alar cartilages not extending to the lateral half of the lateral crus is performed.

The alar height should be 5 mm in the place of the new domes and 7 mm lateral to the new domes.

The new domes are formed by placing transdomal sutures 2 mm from the new domes.

A columellar strut graft is placed between crural footplates and the new domes.

An anterior suture 6 mm below the new domes is placed to achieve a luminous aesthetic triangle at the level of the nasal tip.

A posterior interdomal suture is placed.

A posterior approximation of the lateral crura 2 mm from the new domes is performed.

Once the rotation is verified, resection of the exceeding caudal septum and redundant vestibular skin is performed.

A septocolumellar suture is placed to repair the nasal tip support mechanisms, and the incisions are closed.

For a full description of the technique and its evaluation in a case series, see https://ja.ma/2s8CpBc‚Äč.

This video depicts a medical procedure and is intended for use by medical professionals.


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