Avoiding Aesthetic Drawbacks and Stigmata in Dorsal Line Preservation Rhinoplasty

Neves JC, Arancibia-Tagle D.

What this paper says

A review article describing how to avoid the appearance drawbacks specific to dorsal preservation rhinoplasty, depending on which preservation approach the surgeon selects.

Overview

The authors frame the history of nasal bridge surgery as a century long contest between removing the hump and preserving it, each with advantages and disadvantages. They state the Joseph resection technique has dominated for the past 30 years despite leaving recognizable surgical signs. Preservation offers an alternative for treating a hump but has its own drawbacks, which the authors suggest is why it faded before returning.

Sections of note

Review article; the abstract reports no patient numbers, no outcomes, no revision rates and no follow up.
The management of the nasal bridge is described as a struggle between resection and preservation for over a century.
The Joseph technique is stated to have dominated the past 30 years despite its surgical stigmas.
Preservation techniques are described as having their own drawbacks, like resective techniques.
The authors suggest these drawbacks explain why preservation techniques declined and are now resurging.
The stated aim is to describe how to avoid the aesthetic drawbacks depending on the selected approach.

What it means for a patient

Both approaches leave characteristic signs; neither is free of them.
The specific drawbacks and how to avoid them are described in the full article, not the abstract.
This is expert opinion. No rates for any drawback are reported.

Why this paper matters

Preservation was promoted largely on avoiding the visible signs left by conventional hump removal, and this article states plainly that it carries signs of its own. That framing is part of the corrective literature following rapid adoption. Which drawbacks occur most often, and at what rate, is not quantified.

Terms

Dorsal preservation: lowering the natural nasal bridge instead of cutting the hump off.
Resection: surgical removal of tissue, here the hump.
Joseph technique: the classic hump removal method named after Jacques Joseph.
Surgical stigma: a visible sign that reveals the nose has been operated on.
Dorsal line: the profile line running down the bridge of the nose.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

From the abstract

“For over a century, discussion on the management of nasal dorsum has been a struggle between the techniques of resection and preservation. This is because, each technique has its advantages and disadvantages, with the Joseph technique dominating over the past 30 years despite its surgical stigmas. The dorsum…”

Excerpt; the full abstract is on PubMed.