Structural Preservation Rhinoplasty: A Hybrid Approach

Abstract

Summary: Structural preservation rhinoplasty merges two popular philosophies of rhinoplasty—structure rhinoplasty and preservation rhinoplasty—in an effort to maximize patient outcomes, aesthetics, and function. This allows the surgeon to both preserve the favorable attributes of the nose, and also to structure the nasal tip and dorsum with grafts to maximize contour and support. The concept of dorsal preservation is to preserve favorable dorsal aesthetic lines without the creation of an “open roof.” However, the addition of some structure concepts can expand the utility of dorsal preservation in primary rhinoplasty patients. The authors discuss these structure concepts and their applicability to dorsal preservation.

Quantifying the Subjective Experience of Nasal Obstruction: A Review

“…44 Structural preservation rhinoplasty combines dorsal preservation with conventional tip modification techniques. 45,46 The SCHNOS-C scores between the two groups of patients demonstrated similar patient satisfaction with nasal appearance postoperatively with both conventional dorsal hump reduction and structural rhinoplasty approaches. 44 Additionally, the SCHNOS-O scores have been shown to decrease postoperatively after both conventional and pushdown dorsal preservation techniques.…”

“…Furthermore, the SCHNOS has been used to compare outcomes between structural preservation techniques and conventional dorsal hump resection [46]. Structural preservation rhinoplasty combines dorsal preservation with conventional tip modification techniques [47,48]. The SCHNOS-C scores between the two groups of patients demonstrated similar patient satisfaction with nasal appearance post-operatively with both conventional dorsal hump reduction and structural rhinoplasty approaches [46].…”

Modified Dorsal Split Preservation Hybrid Rhinoplasty for Cartilaginous Pushdown and Full Letdown Applications: A PROM-Based Review of 100 Consecutive Cases

“…12,13 Classifications progressively evolved, with consensus finally uniformly identifying "surface" versus "foundation" techniques and their technical variations. 4,7,11,15 It also became evident that, for some surgeons born and raised to the structural approach, integrating preservation principles in their practice would be made easier by a "hybrid" Table 3 Mean changes (SD, effect size: L approach. For us and others, this essentially means an open rhinoplasty with preservation of the dorsum and structural reediting of the tip while preserving/reconstructing ligaments as far as possible.…”

“…3,4,14 This contemporary concept essentially constitutes a "hybrid" preservation-structural approach. 14,15 We first published our concept of "modified dorsal split (MDS) preservation" in 2019 following several revisions since it had been submitted in 2018. 16 To our knowledge, this was the first time that the "cartilaginous pushdown" (CPD) concept was expressed, on the ground that many nasal humps are in fact prevalently cartilaginous.…”

Gender Affirmation Surgery of the Face for the Transfeminine Patient

“…Many techniques such as preservation rhinoplasty, auto spreader grafts, are now increasingly being practiced. 21 However individual preferences will lead the surgeon to make the decision which best aligns with the patients' goals.…”