Background Supratip depression is a common complication after preservation rhinoplasty. Objectives This paper presents a simple surgical maneuver to prevent supratip depression. Methods Thirty-six patients who underwent closed-approach low-septal-resection dorsal preservation rhinoplasty between January and June 2021 were included in this retrospective study. Depending on the operation performed on Pitanguy’s midline ligament, the patients were divided into two main groups as follows: (1) a group in which Pitanguy’s midline ligament was transected (the transection group), and (2) a group in which Pitanguy’s midline ligament was preserved (the preservation group). Standardized postoperative 6-month lateral-view photographs were scanned for the presence of supratip depression or pollybeak deformity. The Rhinoplasty Outcome Evaluation (ROE) scale was applied at 6 months. Results Supratip depression was observed in four patients in the preservation group (n = 16), and it was not observed in any of the patients in the transection group (n = 20; p < 0.05). There was no pollybeak deformity in either group. For the ROE scores and number of satisfied patients, no statistically significant difference was found between the groups with Pitanguy’s midline ligament transected versus preserved (p > 0.05). Conclusions Transecting Pitanguy’s midline ligament reduces the likelihood of supratip depression and does not affect the likelihood of pollybeak deformity in closed-approach low-septal-resection dorsal preservation rhinoplasty.

Background: Fixation of the cartilaginous vault is an important maneuver in preservation rhinoplasty to reduce hump recurrences. This paper presents a cartilaginous vault fixation technique with a barbed suture. Methods: Forty-six patients who underwent closed-approach high-septal-resection dorsal preservation rhinoplasty between August 2019 and March 2020 were included in this retrospective study. According to the cartilaginous vault fixation sutures applied, the patients were divided into two main groups as follows: (i) barbed suture and (ii) conventional suture. Standardized postoperative 1-month lateral view photographs were scanned for the presence of any degree of hump recurrence. The Rhinoplasty Outcome Evaluation (ROE) scale was applied at 12 months. Results: Hump recurrence was detected in one patient in the barbed suture group (n = 21) and one patient in the conventional suture group (n = 25; p > 0.05). For the ROE scores and number of satisfied patients, no statistically significant difference was found between the barbed and conventional suture fixation techniques (p > 0.05). Conclusions: Fixation with barbed suture showed similar results to conventional suture fixation. Barbed sutures can be used for cartilaginous vault fixation, taking advantage of the ease of placement in closed rhinoplasty.