Global Practice Patterns of Dorsal Preservation Rhinoplasty

Overview

Dorsal preservation rhinoplasty has drawn substantial academic attention, partly on theoretical advantages over techniques that cut the hump away. This study assessed how the technique is used around the world. An 11 item questionnaire was distributed electronically to regional academies and societies representing rhinoplasty surgeons, and responses were analysed by geographic location.

Sections of note

• Survey with 836 responses from regional societies worldwide.
• Early publications on the technique came largely from Western Europe and the United States.
• Turkey and Mexico currently show the greatest use of the technique.
• Familiarity across many regions appears to come from courses and conferences rather than from formal training.
• Mexico shows the greatest exposure to the technique during training.
• One hundred and twenty five respondents had previously used the technique and abandoned it.
• Reasons cited for abandoning it were poor results, less predictability and complications, largely recurrence of the hump.
• The authors conclude practice varies by region and will likely keep evolving.

What it means for a patient

• Whether a surgeon offers this technique depends heavily on where they trained and practice.
• A substantial group of surgeons tried it and stopped, most often because the hump came back.
• Most surgeons who use it learned it at courses rather than during formal training.
• Survey respondents self select, so these figures represent those who answered rather than all surgeons.

Why this paper matters

Technique adoption reveals what surgeons find works in their own hands, which is information not captured in published case series. This survey documents both uptake and abandonment, including the reasons. Whether hump recurrence reflects the technique or the learning curve is not resolved.

Terms

• Dorsal preservation rhinoplasty: lowering the natural nasal bridge instead of cutting the hump off.
• Excisional method: the conventional approach that removes the hump.
• Hump recurrence: the bump on the bridge becoming visible again after surgery.
• Practice pattern: how a technique is actually used across a population of surgeons.