Research Article
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Oblique Submucosal Transdomal Sutures

Year 2026, Volume: 9 Issue: 1, 10 - 15, 26.03.2026
https://doi.org/10.65396/ejra.1894310
https://izlik.org/JA68EE89SW

Abstract

Objective:
To evaluate the functional and aesthetic outcomes of the Oblique Submucosal Transdomal Suture (OSTS) technique in achieving nostril narrowing and enhancing nasal tip stability.

Methods:
The OSTS technique is a multi-vector, submucosal, transdomal suture configuration designed to reinforce the dome complex and restore an ideal resting/leaning angle between the medial and lateral crura.
This study retrospectively analyzed 50 patients who underwent the OSTS technique as part of primary or secondary rhinoplasty procedures. Demographics, operative characteristics, surgeon aesthetic scores, patient satisfaction scores, complications, and follow-up durations were reviewed.

Results:
Among 50 cases, 71.4% underwent primary rhinoplasty and 28.6% secondary procedures. The most common indications were wide nostrils (64.3%) and insufficient tip projection (35.7%). Postoperative surgeon grading ranged from 6–10, and patient satisfaction scores ranged from 4–10 across all cases. No major complications were reported. Follow-up ranged from 12 to 18 months, with a stable reduction in nostril width and preservation of tip position. The OSTS technique effectively increased dome stability while preventing cephalic widening at the medial–middle crus transition zone.

Conclusion:
The OSTS method offers a reliable, minimally disruptive approach to narrowing wide nostrils while enhancing tip stability. Its oblique, multi-plane suture orientation reinforces the dome complex, minimizes unwanted convexity, and yields high functional and aesthetic satisfaction. The technique is particularly advantageous in patients with weak dome structures or those requiring precise refinement of the nostril base.

Ethical Statement

Ethics Committee Approval: This study strictly followed the principles outlined in the Declaration of Helsinki. Ethical approval was obtained from the Bezmialem Vakıf University (meeting date: 16.2.2026; Decision No: E-54022451-050.04-231536).

Supporting Institution

N/A

Project Number

N/A

References

  • 1. Fagundes MS, Moreira AT, Tambara EM, Tenório SB, Fraga RD, Hamerschmidt R. An objective evaluation of surgical technique in variations of rotation and nasal projection. Brazilian Journal of Otorhinolaryngology. 2016;82:47–55.
  • 2. Yağci, Z. G., Bayar Muluk, N., Yazir, M., Yağci, T., Özdemir, E., & Cingi, C. (2025). The Reasons Why Individuals Who Have Facial Aesthetics Constantly Want More and More. The Journal of craniofacial surgery, 10.1097/SCS.0000000000011610. Advance online publication. https://doi.org/10.1097/SCS.0000000000011610
  • 3. Yücel S, Ünverdi ÖF. A new way to change the dynamics of the nasal tip is to use a modified cartilage-sparing tip plasty technique with a hemitransdomal suture and submucosal dissection. Journal of Craniofacial Surgery. January 1, 2020; 31(1):219–21.
  • 4. Cingi C, Muluk NB, Ulusoy S, Söken H, Altintoprak N, Şahin E, and Ada S. wrote "Nasal tip sutures: techniques and indications." The American Journal of Rhinology and Allergy. November 2015; 29(6):e205-11.
  • 5. Coviello, C. M., Varghese, J., Ramirez, A., & Brissett, A. E. (2026). Contemporary Management of Caudal Septal Deformities: An Algorithmic Approach. Facial plastic surgery : FPS, 10.1055/a-2764-3420.
  • 6. Serdev NP. Transcutaneous and transmucosal Serdev Sutures for refining the nasal tip, narrowing the alar base, and making additional modifications. Rhinoplasty using Mini-Invasive Techniques. March 9, 2016, 37–56.
  • 7. Cho BC, Lee JW, Lee JS, Lee JH, Ryu JY, Tian L, Choi KY, Yang JD, Chung HY. Correction of secondary unilateral cleft lip nasal deformity in adults utilizing lower lateral cartilage repositioning, columellar strut, and onlay cartilage graft at the nasal tip through open rhinoplasty combined with a reverse-U incision. Journal of Plastic, Reconstructive, and Aesthetic Surgery. May 1, 2021; 74(5):1077–86.
  • 8. Buttarelli, F., & Saman, M. (2025). Combining Preservation Concepts and Structural Techniques in Nasal Tip Management: A Practical Approach. Facial plastic surgery : FPS, 10.1055/a-2764-3319.
  • 9. Rahimian H and Sajjadian A wrote a book called "Middle Eastern Rhinoplasty: Balancing Form, Function, and Ethnic Harmony." Plastic surgery for looks. August 25, 2025:1–3.
  • 10. Momeni A and Gruber RP did the first open rhinoplasty. Journal of Aesthetic Surgery. October 1, 2016; 36(9):983-92.
  • 11. Rohrich RJ, Ahmad J. A pragmatic methodology for rhinoplasty. Surgery for plastic and reconstruction. April 1, 2016, 137(4):725e–46e.
  • 12. Irmak F, Serin M, Sirvan SS, Yazar SK, Kuran I, Sevim KZ, Karsidag S. Tip reinforcement flap: a novel method for enhancing nasal tip support and contour. Annals of Plastic Surgery. June 1, 2019; 82(6):604–8.
  • 13. Sajjadian A. Rhinoplasty for people from the Middle East. Plastic Surgery Clinics. January 1, 2016; 43(1):281–94.
  • 14. Fisher MD, Fisher DM, and Marcus JR. Fixing the cleft nasal malformation from birth to adulthood. Plastic Surgery Clinics. April 1, 2014; 41(2):283–99.
  • 15. Tanna N, Nguyen KT, Ghavami A, Calvert JW, Guyuron B, Rohrich RJ, Gruber RP. Evidence-based medicine: contemporary methodologies in rhinoplasty. Surgery to fix and change the shape of plastic. January 1, 2018; 141(1):137e-51e.
  • 16. Wong BJ, Friedman O, and Hamilton GS talk about grafting methods in primary and revision rhinoplasty. Clinics for facial plastic surgery. May 1, 2018; 26(2):205–23.
There are 16 citations in total.

Details

Primary Language English
Subjects Otorhinolaryngology
Journal Section Research Article
Authors

Umur Akıner

Project Number N/A
Submission Date February 20, 2026
Acceptance Date March 7, 2026
Publication Date March 26, 2026
DOI https://doi.org/10.65396/ejra.1894310
IZ https://izlik.org/JA68EE89SW
Published in Issue Year 2026 Volume: 9 Issue: 1

Cite

APA Akıner, U. (2026). Oblique Submucosal Transdomal Sutures. European Journal of Rhinology and Allergy, 9(1), 10-15. https://doi.org/10.65396/ejra.1894310
AMA 1.Akıner U. Oblique Submucosal Transdomal Sutures. Eur J Rhinol Allergy. 2026;9(1):10-15. doi:10.65396/ejra.1894310
Chicago Akıner, Umur. 2026. “Oblique Submucosal Transdomal Sutures”. European Journal of Rhinology and Allergy 9 (1): 10-15. https://doi.org/10.65396/ejra.1894310.
EndNote Akıner U (March 1, 2026) Oblique Submucosal Transdomal Sutures. European Journal of Rhinology and Allergy 9 1 10–15.
IEEE [1]U. Akıner, “Oblique Submucosal Transdomal Sutures”, Eur J Rhinol Allergy, vol. 9, no. 1, pp. 10–15, Mar. 2026, doi: 10.65396/ejra.1894310.
ISNAD Akıner, Umur. “Oblique Submucosal Transdomal Sutures”. European Journal of Rhinology and Allergy 9/1 (March 1, 2026): 10-15. https://doi.org/10.65396/ejra.1894310.
JAMA 1.Akıner U. Oblique Submucosal Transdomal Sutures. Eur J Rhinol Allergy. 2026;9:10–15.
MLA Akıner, Umur. “Oblique Submucosal Transdomal Sutures”. European Journal of Rhinology and Allergy, vol. 9, no. 1, Mar. 2026, pp. 10-15, doi:10.65396/ejra.1894310.
Vancouver 1.Umur Akıner. Oblique Submucosal Transdomal Sutures. Eur J Rhinol Allergy. 2026 Mar. 1;9(1):10-5. doi:10.65396/ejra.1894310

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