Advancing Preservation Rhinoplasty: The J-Suture Technique for Refining the Middle Third of the Nose

Overview

Widening of the middle third is a common problem in preservation rhinoplasty, since the bridge is lowered as a unit and its width is not directly reduced. The authors introduce the J-suture technique for refining that region while keeping the bridge intact. It follows principles established by Teoman Dogan and can be performed through either an open or a closed approach.

Sections of note

• Article type: technique description. No patient numbers, outcomes or complication rates are reported.
• Applicable through both open and closed approaches.
• The technique maintains the integrity of the nasal bridge.
• Target problem: widening of the middle third of the nose, described as common in preservation rhinoplasty.
• Method: an absorbable suture passed through the skin approximates the upper lateral cartilages, thinning the middle third.
• Stated advantages: simplicity, predictability, reproducibility and ease of execution.
• The authors state it requires minimal training and can be adopted by any surgeon practising preservation rhinoplasty.

What it means for a patient

• Preservation techniques lower the bridge but do not narrow it, so the middle of the nose can look wider afterward.
• The suture is absorbable and passed through the skin, so no incision or graft is added.
• The abstract carries no findings. It reports no patient numbers, measurements, complication rates or follow up.
• Claims of predictability and reproducibility are stated by the authors rather than demonstrated.

Why this paper matters

Widening of the middle third is one of the recognized limitations of preservation rhinoplasty, alongside hump recurrence, and it has fewer described solutions. A suture technique that needs no graft or incision is a low cost answer. Whether the narrowing holds after the suture absorbs is unaddressed.

Terms

• Preservation rhinoplasty: reshaping that keeps native nasal structures intact.
• Middle third: the middle segment of the nose, formed by the upper lateral cartilages and septum.
• Upper lateral cartilages: the paired cartilages forming the middle third of the nose.
• Percutaneous: passed through the skin.
• Absorbable suture: a stitch the body breaks down and reabsorbs over weeks or months.
• Approximation: drawing two structures closer together.