June Newsletter 2024

Preservation Rhinoplasty vs Traditional Rhinoplasty

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DR. MARK BEATY

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.

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. 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 not be enough room beneath the external structures to accomplish needed changes. In some instances, there may be functional nasal problems which require taking

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