Preservation Rhinoplasty: A Decade of Progress and Technical Refinement

Nissan ME, Kosins A.

What this paper says

A narrative review summarising how preservation rhinoplasty developed over eight years, which techniques a beginner should learn in what order, and the complications to expect.

Overview

This is an expert review, not a study. Nissan and Kosins (Kosins is one of the surgeons who popularised the term) trace the history of preservation rhinoplasty since the term was introduced, describe the prevailing techniques in a sequence a novice surgeon could follow, and list known complications and pitfalls. There are no patients, outcomes or numbers in the abstract; it is graded Level of Evidence 5.

Sections of note

The term "preservation rhinoplasty" was introduced eight years before publication and the authors state it is now an accepted philosophy worldwide.
The stated rationale: stable results with fewer secondary deformities than deconstruction-reconstruction (structural) rhinoplasty.
Techniques are described in a logical learning order for surgeons new to the approach.
Textbooks, journal articles and in-person courses have made the methods more accessible than five years earlier.
A section covers known complications and pitfalls.

What it means for a patient

Preservation rhinoplasty is now a mainstream option, but this paper is an overview of opinion and technique, not a comparison of results.
Complications exist for preservation techniques as for any other; the paper catalogues them.
A surgeon's training path in these techniques matters; the paper is aimed at teaching that path.

Why this paper matters

It is a state-of-the-field summary by an author closely tied to the movement, useful as an orientation to the literature. Limits: no data, Level 5 evidence, and written by proponents of the approach.

Terms

Preservation rhinoplasty: a philosophy that keeps the nasal bridge, ligaments and skin attachments intact and reshapes by repositioning rather than removing.
Structural rhinoplasty: the older "take apart and rebuild" approach using grafts to restore support.
Secondary deformity: a visible or functional problem that appears after healing and may need revision surgery.
Level of Evidence 5: expert opinion, the lowest evidence grade.

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

From the abstract

“Eight years have passed since the introduction of the term "preservation rhinoplasty." This approach has now gained worldwide popularity, and it is clear that preservation rhinoplasty has become an accepted philosophy due to its ability to produce stable, reliable, and beautiful results while minimizing the likelihood…”

Excerpt; the full abstract is on PubMed.