Is Preservation rhinoplasty better than traditional rhinoplasty?
Recently there has been a surge in interest from patients and rhinoplasty surgeons in preservation rhinoplasty. Preservation rhinoplasty is a technique in which modifications to the nasal dorsum are made by releasing and/or removing tissue from beneath the hump or contour irregularity, correcting the aesthetic appearance of the nose while also preserving the natural anatomy of the nasal dorsum or bridge. Preservation rhinoplasty has actually been described for over a century as a technique though for most of that time it has been performed much less frequently than structural rhinoplasty.
What is the difference between preservation rhinoplasty and traditional rhinoplasty?
The main difference between preservation and structural approaches to the nasal dorsum involve how the hump and contour irregularities are managed. In the preservation approach the external structures of the nasal dorsum remain intact whereas in the structural approach they are taken apart, modified and reconstructed. Each method has advantages and disadvantages so one is not “better” than the other though each method has applications and indications it is better suited for.
What is the advantage of a preservation rhinoplasty?
The main advantage of preservation rhinoplasty is that since the dorsal structures are not taken apart, the natural stability and evenness of the nasal structures remain intact. All the release and lowering of nasal structures is performed from below, on the inside of the nose. An additional advantage of this approach is that there is less likelihood of irregularities from incisions and tissue removal developing over time as the skin-soft tissue envelope contracts. There are limitations to the technique as well. In patients with very pronounced humps, crooked nose deformities or very long nasal bones there may notbe enough room beneath the external structures to accomplish needed changes. In some instances, there may be functional nasal problems which require taking apart the dorsal nasal structure and adding grafts to increase the size of the airway. In these situations a structural approach may be the preferred choice.
Who should perform a preservation rhinoplasty?
In summary, preservation rhinoplasty is a well-tested approach which offers advantages in some cases. During consultation with an experienced rhinoplasty surgeon, most often a facial plastic surgeon, who performs both structural and preservation procedures, part of the discussion will be centered on which approach is the best fit for your particular nasal anatomy and cosmetic goals. It is not so much that one procedure is better than the other, but rather selecting the approach that is best for you.
