Dorsal Preservation versus Conventional Hump Reduction Rhinoplasty: A Seven-Year Review of Patient Reported Outcomes and Concurrent Operative Techniques

Wei EX, Fu B, Huang H, Xu L, Kandathil C, Most SP.

PubMed 42053436 Publisher (DOI)

What this paper says

In 377 Stanford patients followed for up to two years, dorsal preservation gave a modest early advantage in patient-rated appearance at 6 months that disappeared by 12 and 24 months, with breathing outcomes equal throughout.

Overview

Most's group retrospectively compared 178 dorsal preservation (DPR) and 199 conventional hump reduction (CHR) patients treated from 2017 to 2024. Outcomes were SCHNOS and VAS scores at baseline and 3, 6, 12 and 24 months, with regression adjusting for age, sex and baseline severity. They also tallied which adjunct techniques accompanied each approach.

Sections of note

Unadjusted: DPR had better SCHNOS-C and VAS-C at 3 and 6 months, with modest absolute differences.
Adjusted: DPR independently associated with better SCHNOS-C at 6 months only.
No aesthetic difference at 12 or 24 months; no functional difference at any time.
CHR patients more often had spreader grafts or autospreaders, anterior septal reconstruction and clocking sutures; DPR patients more often had supratip, radix and underlay articulated rim grafts.
Level of Evidence 3; the authors call the findings associative, not causal.

What it means for a patient

Preservation patients may look "done" slightly sooner, but by one year both groups rated their noses the same.
Breathing results were identical between approaches in this large series.
Each approach comes with its own set of add-on techniques; the choice depends on the nose, not the label.

Why this paper matters

It is one of the largest and longest patient-reported comparisons of the two philosophies, from a centre that does both. Limits: retrospective, non-randomised, and technique selection was driven by anatomy.

Terms

SCHNOS-C / SCHNOS-O: the cosmetic and obstruction subscales of a validated nasal questionnaire.
VAS-C: a visual analogue rating of appearance.
Autospreader: the upper lateral cartilage folded inward to act as a spreader graft.
Anterior septal reconstruction (ASR): rebuilding the front of the septum with grafts.
Articulated rim graft: a cartilage strip along the nostril rim attached to the tip complex.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“To compare early and long-term patient-reported outcomes following dorsal preservation rhinoplasty (DPR) versus conventional hump reduction (CHR) in patients undergoing primary nasal dorsal reduction. Methods: We conducted a retrospective cohort study of 377 patients who underwent DPR (n = 178) or CHR (n = 199)…”

Excerpt; the full abstract is on PubMed.