Feasibility of Dorsal Preservation Rhinoplasty for Hump Nose Reduction in Asian Population

Overview

Dorsal preservation lowers the hump while keeping the bridge surface intact, and its record comes largely from Western populations. The authors assessed whether it works in Asian noses, which differ in skin thickness and cartilage strength. They retrospectively reviewed patients who had primary dorsal preservation between April 2019 and November 2022 with more than 12 months of follow up and photographs meeting their criteria.

Sections of note

• Design: retrospective review, 17 patients, 11 women. Mean age 22.53 years. Median follow up 36.90 months, range 13 to 61.
• Photographic measurement showed significant reduction in the nasofacial angle by 7.76 degrees and the rhinion angle by 0.85 degrees, both p less than 0.0001.
• NOSE blockage scores fell from 61.00, standard deviation 26.96, to 15.50, standard deviation 11.65.
• Postoperative SCHNOS scores: 10.90 overall, with the functional component at 3.50 and the aesthetic component at 7.40.
• No residual hump, hump recurrence or complications were observed.
• The authors state careful patient selection will be needed to define the ultimate indications.

What it means for a patient

• The hump was removed without leaving a bump or having one come back, over a median follow up of about three years.
• Breathing scores fell by roughly three quarters, from severe to mild blockage on the NOSE scale.
• Follow up here is longer than in most preservation series, which matters because hump recurrence typically develops over time.
• Limits: 17 patients, one practice, retrospective, no comparison group, and patients selected partly by whether their photographs met criteria.

Why this paper matters

Hump recurrence is the acknowledged weakness of dorsal preservation, and reporting none across a median of three years in a population where the technique is less established is notable. Seventeen patients is too few to establish a recurrence rate. The authors themselves frame this as defining who the technique suits rather than as a general endorsement.

Terms

• Dorsal preservation rhinoplasty: lowering the bridge while keeping its natural surface intact.
• Dorsal hump: the bump of bone and cartilage on the bridge of the nose.
• Nasofacial angle: the angle between the bridge of the nose and the plane of the face.
• Rhinion: the point on the bridge where nasal bone meets cartilage.
• NOSE scale: a questionnaire measuring nasal blockage, where higher means worse.
• SCHNOS: a validated questionnaire scoring both nasal appearance and nasal blockage.