Incorporating Dorsal Preservation Rhinoplasty into Your Practice

Overview

The article addresses surgeons considering adding dorsal preservation to their practice. Dorsal preservation lowers the natural bridge rather than cutting the hump away, which the author contrasts with component reduction, the conventional method of taking the hump down piece by piece. The stated position is that preservation gives excellent results in patients where component reduction is difficult.

Sections of note

• Review article; the abstract reports no patient numbers, no outcomes, no complication rates and no follow up.
• The author states surgery of the bridge has never been so dynamic or as easily learned.
• An expanding set of dorsal preservation techniques is described as evolving, with each operation building on the others.
• Understanding these techniques is said to require new familiarity with the cartilaginous septum, the perpendicular plate of the ethmoid, nasal osteotomies and anatomy not encountered in component reduction.
• The stated result is preservation of normal anatomy.

What it means for a patient

• Preservation and conventional hump reduction are two different ways of lowering a bridge; this article promotes the first.
• The claim that results are better is the author's assessment, with no data in the abstract.
• The article is written for surgeons adopting the technique, not as evidence of outcomes.

Why this paper matters

Dorsal preservation returned to widespread use in the late 2010s, and adoption depends on surgeons learning unfamiliar anatomy. This article is part of that instructional literature. It does not compare preservation against component reduction in any measured way.

Terms

• Dorsal preservation: lowering the natural nasal bridge instead of removing the hump.
• Component reduction: the conventional approach, taking down bone and cartilage of the hump separately.
• Cartilaginous septum: the cartilage part of the central partition inside the nose.
• Perpendicular plate of the ethmoid: the thin bone forming the upper rear part of the septum.
• Osteotomy: a controlled cut in bone to reposition it.