2018
DOI: 10.1093/asj/sjx180
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Dorsal Preservation: The Push Down Technique Reassessed

Abstract: Management of the nasal dorsum remains a challenge in rhinoplasty surgery. Currently, the majority of reduction rhinoplasties results in destruction of the keystone area (K-area), which requires reconstruction with either spreader grafts or spreader flaps, both for aesthetic and functional reasons. This article will present the senior author's current operative technique for dorsal preservation in reduction rhinoplasty based on 320 clinical cases performed over a 5-year period. The author's operative technique… Show more

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Cited by 224 publications
(227 citation statements)
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“…In complete DP, instead of paramedian osteotomies and an infracture, there are transverse bone cuts connecting a low lateral and a transverse radix osteotomy. 1 It is important to understand the anatomy at the radix. Very often three bones are present-the nasal bone which is often quite thin but is fused on top of the spine of the frontal bone (a joint called a gomphosis); underneath this there is either a cranial extension of the cartilaginous septum or the thin PPE.…”
Section: Discussionmentioning
confidence: 99%
“…In complete DP, instead of paramedian osteotomies and an infracture, there are transverse bone cuts connecting a low lateral and a transverse radix osteotomy. 1 It is important to understand the anatomy at the radix. Very often three bones are present-the nasal bone which is often quite thin but is fused on top of the spine of the frontal bone (a joint called a gomphosis); underneath this there is either a cranial extension of the cartilaginous septum or the thin PPE.…”
Section: Discussionmentioning
confidence: 99%
“…In recent years, much interest has refocused on the place of the push-down and let-down techniques to reduce the dorsal profile, as espoused by Yves Saban for decades and newly discovered by many others. [113][114][115][116][117][118] At this time, it is still a minority approach, but much debate is pursuing a consensus opinion. This may or may not be found.…”
Section: The Nasal Dorsummentioning
confidence: 99%
“…The push-down technique is an older technique, which is gaining popularity and is referred to as "preservation rhinoplasty." 21,22 This technique can be applied in case of a small bony hump and a prominent, often narrow, bony nasal vault. Lateral, transverse, or root osteotomies are combined with a subdorsal septal strip resection.…”
Section: Profile Reductionmentioning
confidence: 99%