Dorsal Preservation Rhinoplasty: A Literature Review

Abstract

Acceptance of the preservation principle in rhinoplasty surgery has increased dramatically, and surgeons worldwide are now performing preservation rhinoplasty, leading to an expanding list of indications and techniques. Rhinoplasty surgeons are increasingly opting for rhinoplasty preservation because of its conservative approach and more predictable outcome. This review aims to evaluate the efficacy of dorsal preservation rhinoplasty, as well as the techniques, indications, surgical protocols, complications, and any practical challenges associated with this type of rhinoplasty. A number of medical databases, including Medline-PubMed, Embase, and Scopus, were searched. These searches were supplemented with a manual search using the keyword “preservation rhinoplasty” (PR) during the 1970 to May 2020 time span. The search strategy was limited to case reports, randomized clinical trials, and prospective studies of preservation dorsal rhinoplasty in journals published in English. A total of 150 articles that incorporated preservation dorsal rhinoplasty as a newer surgical technique were reviewed: 136 from PubMed, 17 experimental studies from Embase, 17 clinical studies from Scopus, and 8 studies identified by data extraction. Preservation rhinoplasty represents a paradigm shift in rhinoplasty philosophy. While techniques continue to improve, the philosophy remains the same: preserving and reshaping the existing nasal structures. Although not all patients benefit from and are satisfied with PR and some may only benefit from partial PR, preserving the anatomy allows for a more intuitive operation and natural results. For a more exhaustive review, readers are encouraged to turn their attention to dorsal preservation as a versatile and adaptable technique. Dorsal preservation avoids long-term issues with the middle vault and keystone area, and the patient benefits from total preservation, as the underlying structure can be reshaped without disruption.

Mobile Bony Cap (Meysem Yorgun Technique): An Innovative Technique in Preservation Rhinoplasty for Crooked Nose Deformity

“…Compared with classical structural rhinoplasty techniques, preservation rhinoplasty is a very popular technique and has many advantages, such as achieving a more natural middle vault. 9 , 10 Because there is no need for middle vault repair, the results are closer to the natural look in terms of the middle vault. In our technique, the middle vault is preserved, the bony cap is mobilized and preserved, and the lateral nasal bones are equalized by a piezo device or classical osteotomes.…”

Golden ratio in dental and facial esthetic: A review of literature

“…While, this study demonstrated no conclusive relationship between facial esthetics and the golden ratio across all ethnicities, the alignment, symmetry, and proportion of the face, which are fundamental elements of facial beauty, are still frequently assessed using the golden ratio in facial analysis (19). Moreover, according to a Stevens et al study in 2021, the golden ratio is a useful tool for facial analysis and dorsal preservation rhinoplasty, which is a surgical procedure that tries to maintain the nose's natural form while enhancing its esthetic (20).…”

Golden proportion and facial esthetic, the harmony and surgical considerations: A review

“…The rate post-rhinoplasty is very low because of the assortment of this technique and the trouble in illustrating patient expectations. The selection of patients is extremely important in rhinoplasty, as excellent surgical outcomes may not happily inspire many patients [23,24].…”