The drooping tip of this patient's nose was permanently lifted by means of the Elasticum thread mounted on a two-tipped needle through a 2 mm incision. This simple new application of Elastic Plastic Surgery enables us to avoid a laborious rhinoplasty operation.
This procedure was carried out by Dr Capurro during a meeting with some Russian surgeons.

The Russian surgeons who were present during this new procedure

A drooping nose-tip may constitute a considerable aesthetic problem. It can also cause breathing difficulties, as an acute nasolabial angle creates turbulence that hinders the entry of air into the nostrils; simply lifting the tip of the nose will enable the patient to breathe more easily. A drooping nose-tip tends to become more accentuated when the patient smiles.

Nose with drooping tip. Design of the pathway of the elastic thread

The nose-tip is lifted by means of the elastic thread under local anesthesia. The procedure lasts only a few minutes. The two-tipped Jano needle is inserted through a 2 mm incision and anchors the EP4 Elasticum thread (Korpo Italy) to the subcutaneous tissues of the procerus muscle. The two-tipped needle is rotated through 180° and continues along its pathway.
To facilitate its passage through the subcutaneous tissue, the Jano needle can be bent slightly. When it reaches the apex of the alar cartilages, the needle travels around the tip of the nose and returns on the other side of the nasal pyramid. The Jano needle fixes the elastic thread to the deep tissues of the procerus and emerges from the tiny entry incision. The two ends of the elastic thread are placed under tension. The tip of the nose is lifted in order to form an upper nasolabial angle of 90° in men and 105° in women. The position is hyper-corrected by about 2 or 3 mm and the two ends of the elastic thread are knotted. The tiny incision is closed by means of an absorbable stitch. A transparent sticking-plaster will keep the nose in the hyper-corrected position for about two weeks.

The nose with the transparent sticking-plaster after implantation of the thread

After two weeks, the nose is re-examined to determine whether any small volumetric modifications are needed; if so, they will be carried out by means of hyaluronic acid or Adipofilling (see.CRPUB.ORG). Adipofilling exerts a potent trophic action on the skin and is frequently used in noses that have undergone rhinoplasty or been damaged.
The elastic thread also enables slight deviations of the anterior portion of the nose to be corrected. In this case, it is enough to straighten the nose with the fingers and to keep it in the desired shape by means of a transparent sticking-plaster for three weeks. As the Elasticum thread is transformed into a ligament, lifting of the nose-tip and straightening of the anterior structures of the nose will be rendered permanent. The geometric configuration of the elliptical suture also has the effect of shrinking the apical portion of the nose-tip.

 

Nose with drooping tip after a week

The indication for this simple procedure is established during the preoperative examination. The nose-tip is pinched between two fingers and is drawn backwards and upwards; if it is raised easily, the elastic thread can be implanted.

Result of lifting the tip of the nose with elastic thread, before and after