Oblique Submucosal Transdomal Sutures

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.