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Facial Plast Surg 2021; 37(01): 086-091
DOI: 10.1055/s-0041-1724031
Original Article

History of Dorsum Conservative Techniques in Rhinoplasty: The Evolution of a Revived Technique

Diego Arancibia-Tagle
1   Department of Otolaryngology and Head and Neck Surgery, Hospital Universitari Son Espases, Palma de Mallorca, Baleares, Spain
,
José Carlos Neves
2   Department of Facial Plastic Surgery, Myface Clinic, Lisboa, Portugal
,
Alwyn D'Souza
3   Department of Otolaryngology/Facial Plastic Surgery, University Hospital Lewisham, London, United Kingdom of Great Britain and Northern Ireland
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Abstract

The correction and management of the nasal hump has been a classic problem in rhinoplasty since the beginning of the aesthetic purpose of this surgery. For many years, the resective technique described by Joseph has been the battle horse to solve this problem but it has several drawbacks if not done properly. In the late 19th and early 20th centuries, a new dorsal conservative technique was born and for several years was an alternative option to treat the same problem without damaging the keystone area while preserving the dorsal connection between the upper lateral cartilage and the septum. The aim of this article is to review the history and evolution of this technique, which has been reborn after several years, and how it has evolved since then.

Keywords

preservation rhinoplasty - dorsum conservative rhinoplasty - dorsum resective rhinoplasty - intermediate split Tetris rhinoplasty - segmental rhinoplasty


Publication History

Article published online:
23 February 2021

© 2021. Thieme. All rights reserved.

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  • References

  • 1 Walker TJ, Toriumi DM. Philosophy and principles of rhinoplasty. In: Papel I, Frodel JL, Holt GR. et al. eds. Facial Plastic and Reconstructive Surgery, Fourth Edition. New York, NY: Thieme Medical and Scientific Publishers; 2016: 401-422
    Search in Google Scholar
  • 2 Cottle MH, Loring RM. Corrective surgery of the external nasal pyramid and the nasal septum for restoration of normal physiology. Ill Med J 1946; 90: 119-135
    Search in Google Scholar
  • 3 Cottle MH. Nasal roof repair and hump removal. AMA Arch Otolaryngol 1954; 60 (04) 408-414
    CrossrefPubMedSearch in Google Scholar
  • 4 Joseph J. The classic reprint: nasal reductions. Plast Reconstr Surg 1971; 47 (01) 79-83
    CrossrefPubMedSearch in Google Scholar
  • 5 Joseph J. Beiträge zur Rhinoplastik. Berl Klin Wochenschrift 1907; 16: 470-472
    PubMedSearch in Google Scholar
  • 6 Saban Y, Daniel RK, Polselli R, Trapasso M, Palhazi P. Dorsal preservation: the push down technique reassessed. Aesthet Surg J 2018; 38 (02) 117-131
    CrossrefPubMedSearch in Google Scholar
  • 7 Saban Y, Braccini F, Polselli R. Morphodynamic anatomy of the nose. In: Saban Y, Braccini F, Polselli R, Micheli-Pellegrini V. Rhinoplasties: The Monographs of CCA Group, no. 32. Paris: 2002: 25-32
    Search in Google Scholar
  • 8 Goodale JL. A new method for the operative correction of exaggerated Roman nose. Boston Med Surg J 1899; 140: 112
    Search in Google Scholar
  • 9 Lothrop OA. An operation for correcting the aquiline nasal deformity; the use of new instrument; report of a case. Boston Med Surg J 1914; 170: 835-837
    CrossrefPubMedSearch in Google Scholar
  • 10 Sebileau P, Dufourmentel L. Correction chirurgicale des difformités congénitales et acquises de la pyramide nasale. Paris: Arnette; 1926: 104-105
    Search in Google Scholar
  • 11 Maurel G. Chirurgie maxilla-faciale. Paris: Le François; 1940: 1127-1133
    Search in Google Scholar
  • 12 Skoog T. A method of hump reduction in rhinoplasty. A technique for preservation of the nasal roof. Arch Otolaryngol 1966; 83 (03) 283-287
    CrossrefPubMedSearch in Google Scholar
  • 13 Huffman WC, Lierle DM. Rhinoplastic surgery; some general considerations. J Iowa State Med Soc 1948; 38 (10) 443-447
    PubMedSearch in Google Scholar
  • 14 Huizing EH. Push-down of the external nasal pyramid by resection of wedges. Rhinology 1975; 13 (04) 185-190
    Search in Google Scholar
  • 15 Willemot J, Vrebos J, Pollet J. et al. [Plastic surgery and otorhinolaryngology] [Article in French]. Acta Otorhinolaryngol Belg 1967; 21: 463-732
    PubMedSearch in Google Scholar
  • 16 Wayoff M, Perrin C. [Global mobilization of the nasal pyramid according to Cottle's technic: its possibilities in functional nose surgery]. Acta Otorhinolaryngol Belg 1968; 22 (06) 675-680
    PubMedSearch in Google Scholar
  • 17 Hinderer KH. Fundamentals of Anatomy and Surgery of the Nose. Ann Arbor, MI: Aesculapius Publishing Co; 1971
    Search in Google Scholar
  • 18 Drumheller GW. The push down operation and septal surgery. Boston: Little, Brown, and Company; 1973
    Search in Google Scholar
  • 19 Barelli PA. Long term evaluation of “push down” procedures. Rhinology 1975; 13 (01) 25-32
    PubMedSearch in Google Scholar
  • 20 Pirsig W, Königs D. Wedge resection in rhinosurgery: a review of the literature and long-term results in a hundred cases. Rhinology 1988; 26 (02) 77-88
    Search in Google Scholar
  • 21 Gola R. [Conservative rhinoplasty]. Ann Chir Plast Esthet 1994; 38 (03) 239-252
    PubMedSearch in Google Scholar
  • 22 Gola R. La Rhinoplastie Fonctionnelle et Esthétique. Paris, France: Springer-Verlag; 2000: 360
    Search in Google Scholar
  • 23 Gola R. Functional and esthetic rhinoplasty. Aesthetic Plast Surg 2003; 27 (05) 390-396
    CrossrefPubMedSearch in Google Scholar
  • 24 Ferraz M, Zappelini C, Carvalho G, Guimarães A, Chone C, Dewes W. Cirurgia conservadora do dorso nasal - a filosofia do reposicionamento e ajuste do septo piramidal (S.P.A.R.). Rev. Bras. Cir. Cabeça Pescoço 2013; 42 (03) 124-130
    PubMedSearch in Google Scholar
  • 25 Dewes W. Rinoplastia conservadora: Septo Piramidal, Ajuste e Reposicionamento De A. Tratado de Otorrinolaringologia e Cirurgia Cérvicofacial Da ABORL-CCF. Philadelphia: Elsevier; 2017: 149
    Search in Google Scholar
  • 26 Ishida J, Ishida LC, Ishida LH, Vieira JC, Ferreira MC. Treatment of the nasal hump with preservation of the cartilaginous framework. Plast Reconstr Surg 1999; 103 (06) 1729-1733 , discussion 1734–1735
    CrossrefPubMedSearch in Google Scholar
  • 27 Ulloa FL. Let down technique. Rhinoplasty Archive (free online surgical textbook). 2011 . Accessed January 11, 2017 at: http://www.rhinoplastyarchive.com/articles/let-down-technique
    Search in Google Scholar
  • 28 Boulanger N, Baumann C, Beurton R. et al. Septorhinoplasty by disarticulation: early assessment of a new technique for morphological correction of crooked noses. Rhinology 2013; 51 (01) 77-87
    CrossrefPubMedSearch in Google Scholar
  • 29 Ferreira MG, Monteiro D, Reis C, Almeida e Sousa C. Spare roof technique: a middle third new technique. Facial Plast Surg 2016; 32 (01) 111-116
    Thieme ConnectPubMedSearch in Google Scholar
  • 30 Neves JC, Arancibia Tagle D, Dewes W, Larrabee Jr. W. The split preservation rhinoplasty: “the Vitruvian Man split maneuver”. Eur J Plast Surg 2020; 43: 323-333
    CrossrefPubMedSearch in Google Scholar
  • 31 Goksel A, Saban Y. Open Piezo preservation rhinoplasty: a case report of the new rhinoplasty approach. Facial Plast Surg 2019; 35 (01) 113-118
    Thieme ConnectPubMedSearch in Google Scholar
  • 32 Neves JC, Arancibia Tagle D, Dewes W, Ferraz M. The segmental preservation rhinoplasty: the split Tetris concept. Facial Plast Surg 2020; [epub] ahead of print
    Thieme ConnectPubMedSearch in Google Scholar
  • 33 Patel PN, Abdelwahab M, Most SP. A review and modification of dorsal preservation rhinoplasty techniques. Facial Plast Surg Aesthet Med 2020; 22 (02) 71-79
    Search in Google Scholar
  • 34 Kovacevic M, Buttler E, Haack S, Riedel F, Veit JA. Die nasenrückenerhaltende „Dorsal-Preservation“-Septorhinoplastik. HNO 2020;
    CrossrefPubMedSearch in Google Scholar
  • 35 Daniel RK. The preservation rhinoplasty: a new rhinoplasty revolution. Aesthet Surg J 2018; 38 (02) 228-229
    CrossrefPubMedSearch in Google Scholar
  • 36 Montes-Bracchini JJ. Nasal profile hump reduction using the let-down technique. Facial Plast Surg 2019; 35 (05) 486-491
    Thieme ConnectPubMedSearch in Google Scholar
  • 37 Tuncel U, Aydogdu O. The probable reasons for dorsal hump problems following let-down/push-down rhinoplasty and solution proposals. Plast Reconstr Surg 2019; 144 (03) 378e-385e
    CrossrefPubMedSearch in Google Scholar
  • 38 Kosins AM, Daniel RK. Decision making in preservation rhinoplasty: a 100 case series with one-year follow-up. Aesthet Surg J 2020; 40 (01) 34-48
    CrossrefPubMedSearch in Google Scholar
  • 39 Kosins AM. Expanding indications for dorsal preservation rhinoplasty with cartilage conversion techniques. Aesthet Surg J 2021; 41 (02) 174-184
    CrossrefPubMedSearch in Google Scholar
  • 40 Finochi V. SPQR technique: simplified preservation of quick rhinoplasty. Medica Jadertina 2020; 50 (Suppl): 14-14
    PubMedSearch in Google Scholar
  • 41 Öztürk G. Push-down technique without osteotomy: a new approach. Aesthetic Plast Surg 2020; 44 (03) 891-901
    CrossrefPubMedSearch in Google Scholar
  • 42 Taş S. Dorsal roof technique for dorsum preservation in rhinoplasty. Aesthet Surg J 2020; 40 (03) 263-275
    CrossrefPubMedSearch in Google Scholar
  • 43 Patel PN, Abdelwahab M, Most SP. A review and modification of dorsal preservation rhinoplasty techniques. Facial Plast Surg Aesthet Med 2020; 22 (02) 71-79
    Search in Google Scholar
  • 44 Abdelwahab MA, Neves CA, Patel PN, Most SP. Impact of dorsal preservation rhinoplasty versus dorsal hump resection on the Internal nasal valve: a quantitative radiological study. Aesthetic Plast Surg 2020; 44 (03) 879-887
    CrossrefPubMedSearch in Google Scholar
  • 45 Ishida LC, Ishida J, Ishida LH, Tartare A, Fernandes RK, Gemperli R. Nasal hump treatment with cartilaginous push-down and preservation of the bony cap. Aesthet Surg J 2020; 40 (11) 1168-1178
    CrossrefPubMedSearch in Google Scholar
  • 46 Daniel RK, Palhazi P, Saban Y, Cakir B. Preservation Rhinoplasty. 3rd ed. Turkey: Septum Publisher; 2020
    Search in Google Scholar