A Segmental Approach in Dorsal Preservation Rhinoplasty: The Tetris Concept

Overview

The authors state that conservative rhinoplasty techniques, which keep the bridge rather than cutting it away, have been described for more than 100 years and have returned to favour among surgeons. The article sets out their philosophy of approaching the bridge as a set of segments, each with its own anatomy and surgical requirements.

Sections of note

• Review and technique article; the abstract reports no patient numbers, no outcomes, no complication rates and no follow up.
• The bridge is approached in segments rather than as a single unit.
• Three named methods are described: the intermediate septal strip approach, the intermediate split and the Tetris concept.
• The authors state they discuss the advantages and limitations of each.
• The stated aim across the article is predictable, accurate and durable long term results.

What it means for a patient

• Segmental means the surgeon treats different parts of the bridge differently rather than lowering it as one block.
• The article names and describes techniques; it reports no results from using them.
• No comparison against other preservation methods or conventional hump removal is presented.

Why this paper matters

Dorsal preservation has generated a rapid succession of named technique variants, and the Tetris concept is among the most cited of them. This article is the descriptive source for that approach. Whether segmental handling improves stability over whole block lowering has not been measured.

Terms

• Dorsal preservation: lowering the natural nasal bridge instead of cutting the hump off.
• Segmental approach: treating separate portions of the bridge with different techniques.
• Septal strip: a strip of cartilage removed from the septum so the bridge can settle down.
• Resective surgery: surgery that removes tissue, here the hump, rather than repositioning it.
• Nasal dorsum: the bridge of the nose.