High dorsal strip rhinoplasty

High dorsal strip rhinoplasty is a technique within the realm of preservation rhinoplasty that focuses on refining the nasal dorsum (the bridge of the nose) while maintaining much of the original anatomical structures. This technique is particularly useful for patients who require reduction of a dorsal hump while aiming to achieve a natural and aesthetically pleasing nasal contour. Here’s a detailed look at high dorsal strip rhinoplasty:

Key Concepts of High Dorsal Strip Rhinoplasty:

1. Dorsal Hump Reduction:
   • Instead of removing the entire dorsal hump, the high dorsal strip technique involves conserving a central strip of the nasal dorsum. This helps maintain the natural dorsum contour while allowing for reduction in height.
2. Preservation of the Natural Dorsal Lines:
   • By keeping a central strip of cartilage and bone intact, the natural dorsal aesthetic lines are preserved, contributing to a more natural post-surgical appearance.
3. Structural Integrity:
   • The technique maintains the structural integrity and support of the nose, which can lead to improved stability and function compared to more invasive procedures.

Procedure of High Dorsal Strip Rhinoplasty:

1. Marking and Planning:
   • Precise markings are made to define the areas of the dorsal hump that need to be reduced while identifying the central strip that will be preserved.
2. Subperichondrial and Subperiosteal Dissection:
   • Similar to other preservation rhinoplasty techniques, dissection is performed under the perichondrium (cartilage covering) and periosteum (bone covering) to ensure minimal disruption to the soft tissue and blood supply.
3. Reshaping the Dorsum:
   • The nasal dorsum is reshaped by removing small, strategic portions of cartilage and bone around the central strip. This allows the height of the dorsum to be reduced without completely altering its natural shape.
4. Repositioning:
   • Any necessary repositioning of the nasal bones is performed, often using controlled fractures to allow the bones to settle into a lower, more aesthetically pleasing position.

Advantages of High Dorsal Strip Rhinoplasty:

1. Natural Results:
   • By preserving the central strip of the dorsum, the technique ensures that the natural lines and contours of the nose are maintained, resulting in a more natural appearance.
2. Improved Nasal Function:
   • The preservation of the dorsal strip helps maintain the structural support of the nose, which can lead to better long-term functional outcomes, particularly in terms of nasal airflow and breathing.
3. Reduced Invasiveness:
   • With less extensive removal of cartilage and bone, the procedure is less invasive, leading to reduced postoperative swelling, bruising, and a quicker recovery time.
4. Stability and Longevity:
   • Maintaining a central strip of cartilage and bone provides ongoing support for the nasal structure, contributing to the stability and longevity of the surgical results.

Ideal Candidates for High Dorsal Strip Rhinoplasty:

• Patients with a Dorsal Hump:
  • Individuals looking to reduce a prominent dorsal hump while maintaining a natural nasal contour are ideal candidates for this technique.
• Those Seeking Natural-Looking Results:
  • Patients who prefer a more conservative approach that preserves the natural aesthetics of their nose may benefit from high dorsal strip rhinoplasty.
• Patients with Good Nasal Structure:
  • Ideal candidates typically have sufficient nasal structural support, allowing for effective reshaping without extensive removal of cartilage and bone.

High dorsal strip rhinoplasty is a refined technique in the field of rhinoplasty, emphasising the preservation of natural nasal structures to achieve both aesthetic and functional benefits. It represents a balance between effective hump reduction and the maintenance of natural nasal contours, leading to pleasing and stable outcomes.