DESCRIPTION: Present a simple suture technique to provide support to the tip in the healing process after rhinoplasty, aiming to prevent loss of rotation.

OBJECTIVES: Show the surgical steps to suspend the nasal tip to the cartilaginous dorsum in open rhinoplasty.

BACKGROUND: Tip stability after rhinoplasty is of paramount importance. Loss of rotation is a known complication and taping is of widespread use, aiming to prevent this from happening. With this in mind, a suturing technique was created to emulate the effect of tip taping, in order to sustain the suspension vector for the duration of the healing process.

This proposal aims to systematically evaluate a novel dorsal augmentation technique in rhinoplasty based on semi-dried, platelet-rich plasma (PRP)–stabilized diced cartilage. Autologous diced cartilage grafts are widely used for dorsal augmentation; however, their inherent fluidity often leads to migration, contour irregularities, and unpredictable handling, particularly in thin-skinned patients. Existing strategies to improve graft stability—such as fascia wrapping, fibrin sealants, or oxidized cellulose—add operative complexity, cost, and potential foreign-body reactions, while still failing to fully address early positional instability. Although biologic carriers such as PRP have demonstrated beneficial effects on cartilage viability and integration, their liquid form limits intraoperative handling and shape control.

The proposed technique introduces a controlled, short-duration air-drying step applied to PRP-saturated diced cartilage, transforming the mixture into a cohesive, moldable, semi-solid graft that can be placed directly onto the nasal dorsum and radix without sutures, wrapping, or adhesive materials. The primary objective of this project is to assess the feasibility, safety, and early clinical behavior of this graft preparation method. Primary outcome objectives include early graft positional stability, absence of migration, maintenance of dorsal contour smoothness, and lack of graft-related complications during standardized postoperative follow-up. Secondary objectives include evaluation of intraoperative handling characteristics, reproducibility of graft consistency, and surgeon-reported ease of contouring compared with conventional diced cartilage techniques.

The scientific rationale for this approach is supported by experimental and clinical evidence demonstrating that brief air-drying is a long-established and safe intraoperative maneuver in otologic and nasal surgery, and that PRP enhances chondrocyte viability and tissue integration. Available data also suggest that short-term exposure to moderate heat does not result in clinically meaningful degradation of platelet-derived growth factors or cartilage integrity. By combining these principles, the proposed method seeks to bridge the gap between biologic enhancement and mechanical stability in dorsal augmentation.

This proposal is designed as an early feasibility and proof-of-concept evaluation to generate structured clinical data that will inform larger prospective studies. If successful, this technique may represent a cost-effective, foreign-material–free, and reproducible alternative for dorsal augmentation, particularly in revision cases and thin-skinned patients where graft stability and surface smoothness are critical.

Modified spare roof technique is a conservative dorsal preservation technique.