Shuttle lifting of the nose: a minimally invasive approach for nose reshaping

Suspension sutures are commonly used in numerous cosmetic surgical procedures. Several authors have described the use of such sutures as a part of classical rhinoplasty. On the other hand, it is not uncommon to see patients seeking nasal surgery for only a minimal hump deformity combined with an underrotated, underprojecting tip, which does not necessarily require all components of rhinoplasty. With the benefit of the suture suspension technique described here, such simple tip deformities can be reshaped percutaneously via minimal incisions. In this study, the author describes 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. Between December 2005 and December 2008, 86 patients were selected to undergo rhinoplasty using the author's shuttle lifting technique. The procedure was performed 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. Mean follow-up was 13 months, with a range of eight to 24 months. Outcomes were satisfactory in all but 12 cases, of which seven found the result inadequate; two of those patients underwent a definitive rhinoplasty operation. Five patients requested that the suture be detached because of an overexaggerated appearance. Operative time was less than 15 minutes in all patients, with an uneventful rapid recovery. As a minimally invasive nasal reshaping procedure, shuttle lifting is a good choice to achieve long-lasting, satisfactory results in selected patients with minimal hump deformity and an underrotated tip. The significance of this technique lies in the fact that it is one of very few office-based minimally invasive alternatives for aesthetic nasal surgery, with a recovery period of two to three days.