Mattress sutures to remove unwanted convexity and concavity of the nasal tip: 12-year follow-up.

Nasal tip bulbosity, or convexity, has been one of the most difficult problems to correct during rhinoplasty. Excision of cartilage from the cephalic part of the lateral crus has helped. However, complete correction of the deformity is not always possible with this maneuver alone. Suture techniques have also helped to improve outcomes. Twelve years ago, the lateral crus mattress suture was introduced as a way of converting the lateral crus to a flat, straight segment with resultant correction of the convexity. Since then, this suture technique has been employed in most primary and some secondary rhinoplasties and has stood the test of time. We report our experience with this technique, including a slight modification to facilitate its application when the cartilage is unusually narrow or when the original technique is difficult to complete. In addition, the suture technique for the less concave lateral crura is redescribed. It, too, has withstood the test of time.