Dorsal preservation rhinoplasty

Dorsal preservation rhinoplasty is a technique within the broader field of preservation rhinoplasty that specifically focuses on maintaining the integrity of the nasal dorsum (the bridge of the nose). This approach aims to achieve the desired aesthetic and functional outcomes while preserving the natural anatomy of the nose. Here are the key aspects of dorsal preservation rhinoplasty:

Key Principles of Dorsal Preservation Rhinoplasty:

1. Preservation of the Nasal Dorsum:
   • Instead of removing and reconstructing the dorsal hump (a common practice in traditional rhinoplasty), dorsal preservation rhinoplasty aims to reshape or lower the dorsum while keeping the original structures intact.
2. Minimal Tissue Removal:
   • The technique involves minimal removal of bone and cartilage. Instead, the surgeon may lower the dorsum by addressing the underlying structures, such as the septum and lateral nasal walls.
3. Maintaining Structural Integrity:
   • By preserving the natural anatomy, dorsal preservation rhinoplasty maintains the nasal structure’s integrity, leading to more stable and natural-looking results.

Techniques Used in Dorsal Preservation Rhinoplasty:

1. Push-Down and Let-Down Techniques:
   • These techniques involve mobilising and repositioning the nasal structures rather than removing them. In the push-down technique, the nasal dorsum is gently pushed down to the desired height. In the let-down technique, controlled cuts are made in the nasal bones, allowing them to settle into a lower position naturally.
2. Subperichondrial and Subperiosteal Dissection:
   • Similar to the SPQR technique, dorsal preservation rhinoplasty often involves subperichondrial (under the cartilage covering) and subperiosteal (under the bone covering) dissection to preserve the soft tissue attachments and ensure better healing.
3. Cartilage Preservation and Modification:
   • The nasal cartilage is preserved and modified to achieve the desired shape and support without extensive removal or grafting.

Advantages of Dorsal Preservation Rhinoplasty:

1. Natural Appearance:
   • By maintaining the natural dorsal lines and contours of the nose, the results tend to look more natural and harmonious with the patient’s facial features.
2. Reduced Risk of Complications:
   • Preserving the nasal structures reduces the risk of complications such as dorsal irregularities, unnatural contours, and postoperative deformities.
3. Improved Nasal Function:
   • The technique is less likely to compromise nasal function, particularly breathing, as the structural integrity of the nose is maintained.
4. Faster Recovery:
   • With less tissue disruption, patients often experience less swelling, bruising, and a quicker recovery period.

Ideal Candidates for Dorsal Preservation Rhinoplasty:

• Patients with a Dorsal Hump:
  • Individuals looking to reduce a dorsal hump while maintaining the natural slope and contour of their nose are ideal candidates for this technique.
• Those Seeking Natural Results:
  • Patients desiring a natural-looking nose that fits harmoniously with their facial features may benefit from dorsal preservation rhinoplasty.
• Patients with Good Nasal Structure:
  • Ideal candidates typically have good structural support in their nasal bones and cartilage, allowing for effective reshaping without extensive removal.

Dorsal preservation rhinoplasty represents a shift towards more conservative and anatomically respectful techniques in nasal surgery, prioritising the preservation of natural structures to achieve aesthetically pleasing and functional outcomes.