What is preservation rhinoplasty?
Preservation rhinoplasty is a blanket term which refers to rhinoplasty procedures which try to preserve the structure of the external nose by repositioning rather than removing tissue components. Most commonly when surgeons talk about preservation rhinoplasty they are referring to preservation dorsum techniques which are ways of improving nasal dorsal lines and/or reducing a hump or elevating a depression WITHOUT violating the intact structure of the nasal bridge. This is in contrast to structural techniques where the hump or irregularities are removed directly and the nasal bridge is reconstructed.
What are the advantages of using this technique for rhinoplasty?
Advantages of preservation dorsum techniques include a lower chance of irregularities developing overtime at the nasal dorsum and when performed in expert hands this procedure can result in more naturaland pleasing dorsal aesthetic lines. The goal is to accomplish the needed changes in nasal shape while leaving the native structure of the external nose intact. Of particular importance is the keystone area, which is where the bone and cartilage of the nasal dorsum come together. In structural techniques, this area is disrupted by removing the hump and must be reconstructed. Preservation rhinoplasty lowers the hump from beneath, leaving the keystone area intact.
Is it a new procedure?
While often promoted as a new technique, dorsal preservation was first described in the late 19 th century. At that point, the method did not gain popularity, largely because of limitations in instrument and exposure technology. Now, with the availability of endoscopy for better visualization and ultrasonic precision osteotomies for precise bone shaping, preservation dorsum rhinoplasty has enjoyed a resurgence in popularity.
Who is a good candidate for preservation rhinoplasty?
As with most surgical techniques, preservation rhinoplasty is not needed or desirable for all patients. The technique does offer the advantages of maintaining intact external nasal structures, reducing post- operative swelling and consequently healing time, and reducing the chances of irregularities appearing over time, particularly in thin-skinned patients. Preservation rhinoplasty does require technical skill and experience so you should discuss with your surgeon their personal experience and comfort level with the procedure as well as why preservation rhinoplasty is right for you. The goal overall is to create the best cosmetic result with the least risk and disruption of normal structures.
