Low Block Hybrid Rhinoplasty as a New Alternative for Mixed-Race Noses

Overview

Rhinoplasty on mixed race noses is described as challenging in Latin America, where thicker skin and weaker cartilage are common. The authors present the low block technique, which aims to preserve the bridge while shaping the tip. Patients were treated at a private centre in Trujillo, Peru between August 2023 and January 2024, with measurements taken by projectometer at five time points.

Sections of note

• Design: case series, 46 patients, 42 women and 4 men, aged 15 to 43, mean 25 years.
• Bridge height and tip projection were measured before surgery, immediately after, and at 1, 3 and 6 months.
• Surgical indications were classified by the authors into types I, II and III based on tissue shape and cartilage quality.
• Distribution: type I in 16 patients, 34.8 percent; type IIa in 6, 13 percent; type IIb in 9, 19.6 percent; type III in 15, 32.6 percent.
• Mean operative time: 198 minutes.
• Measurements before and after surgery differed significantly, p less than 0.05, and remained stable through six months.
• No adverse events occurred.

What it means for a patient

• The technique targets both goals at once: keeping the bridge intact while building the tip, which is the usual requirement in thicker skinned noses.
• Measurements held steady from immediately after surgery through six months, though six months is early for settling to be complete.
• Nearly three and a half hours of operating time is substantial.
• Limits: 46 patients, one centre, no comparison group, no patient satisfaction scores, and six months of follow up.

Why this paper matters

Preservation techniques were developed on thin skinned noses with strong cartilage, and applying them to mixed race anatomy requires modification. Documenting stability with serial measurement rather than photographs alone is a methodological strength. Six months cannot establish whether the correction holds, particularly for hump recurrence.

Terms

• Mixed-race nose: a nasal type combining features associated with different ancestries.
• Hybrid rhinoplasty: combining preservation and structural techniques in one operation.
• Dorsum: the bridge of the nose, running from between the eyes to the tip.
• Tip projection: how far the nasal tip stands out from the plane of the face.
• Projectometer: an instrument for measuring how far a structure projects.
• Cartilage quality: how strong and rigid the patient's own cartilage is.