Our Summary

This research paper discusses a renewed interest in a type of nose surgery called dorsal preservation rhinoplasty (DPR), which is used to reshape the nose. This method has potential aesthetic and functional benefits compared to the traditional hump resection technique. DPR involves lowering the nasal bridge through a combination of removing some of the cartilage septum and moving the bone structure. There are several different ways to perform DPR, allowing more people to be suitable for this procedure. While studies show that these techniques can be successful, there isn’t a lot of data comparing DPR to the traditional technique. Some challenges with DPR include a step-off at the root of the nose, the hump coming back, a dip above the tip of the nose, and widening of the middle part of the nose. The paper suggests that merging structural techniques with preservation methods will help incorporate DPR more into clinical practice.

FAQs

  1. What is Dorsal Preservation Rhinoplasty (DPR)?
  2. What are some of the potential challenges and complications associated with DPR?
  3. How does DPR compare to conventional hump resection in terms of success rates?

Doctor’s Tip

A doctor may tell a patient considering rhinoplasty to consider dorsal preservation rhinoplasty as a potential option, as it offers both aesthetic and functional benefits compared to conventional hump resection. It is important for the patient to understand the potential challenges and stigmata associated with this technique, such as a radix step-off, hump recurrence, supratip saddling, and widening of the midvault. The doctor may also emphasize the importance of finding a skilled and experienced surgeon who is knowledgeable in both traditional and preservation techniques to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for rhinoplasty include those with:

  1. Dorsal hump deformity: Patients with a prominent dorsal hump or bump on the bridge of the nose may benefit from rhinoplasty to achieve a smoother profile.

  2. Nasal asymmetry: Patients with asymmetry or crookedness of the nose may benefit from rhinoplasty to improve facial symmetry.

  3. Breathing problems: Patients with nasal obstruction or breathing difficulties due to a deviated septum or other structural issues may benefit from rhinoplasty to improve nasal airflow.

  4. Post-traumatic deformities: Patients who have experienced nasal trauma or injury resulting in a deformity may benefit from rhinoplasty to restore the nose’s appearance and function.

  5. Congenital deformities: Patients born with nasal deformities such as a cleft lip or palate may benefit from rhinoplasty to improve the appearance and function of the nose.

  6. Aging changes: Patients experiencing changes in the shape or size of the nose due to aging may benefit from rhinoplasty to rejuvenate their appearance.

Overall, rhinoplasty can be recommended for a wide range of patients seeking to improve both the aesthetic appearance and functional aspects of their nose.

Timeline

Before rhinoplasty:

  1. Patient consultation: The patient meets with a plastic surgeon to discuss their goals, expectations, and concerns regarding their nose shape and appearance.
  2. Pre-operative assessment: The surgeon evaluates the patient’s nasal structure, skin thickness, and overall health to determine if they are a suitable candidate for rhinoplasty.
  3. Surgical planning: The surgeon creates a personalized surgical plan based on the patient’s desired outcomes and anatomical considerations.
  4. Pre-operative instructions: The patient receives instructions on how to prepare for surgery, including avoiding certain medications, smoking, and alcohol consumption.

After rhinoplasty:

  1. Immediate post-operative period: The patient wakes up in the recovery room with bandages and possibly a nasal splint in place to support the newly shaped nose.
  2. Pain management: The patient may experience discomfort and swelling in the days following surgery, which can be managed with prescribed pain medications.
  3. Follow-up appointments: The patient will have several follow-up appointments with the surgeon to monitor healing progress, remove sutures, and adjust any splints or bandages.
  4. Swelling and bruising: Swelling and bruising around the nose and eyes are common after rhinoplasty and may take several weeks to fully resolve.
  5. Long-term results: It can take several months to a year for the final results of rhinoplasty to be fully visible as the swelling subsides and the nose settles into its new shape.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with dorsal preservation rhinoplasty compared to conventional hump resection?

  2. How will dorsal preservation rhinoplasty impact the overall appearance of my nose?

  3. What is the recovery process like for dorsal preservation rhinoplasty, and how long can I expect it to take?

  4. Will dorsal preservation rhinoplasty improve my breathing or address any functional issues with my nose?

  5. Can you provide before and after photos of previous patients who have undergone dorsal preservation rhinoplasty?

  6. What specific techniques will you be using during the dorsal preservation rhinoplasty procedure?

  7. How many dorsal preservation rhinoplasty procedures have you performed, and what is your success rate with this technique?

  8. Will I need any additional procedures or treatments in conjunction with dorsal preservation rhinoplasty to achieve my desired results?

  9. How long can I expect the results of dorsal preservation rhinoplasty to last?

  10. Are there any lifestyle changes or restrictions I should be aware of after undergoing dorsal preservation rhinoplasty?

Reference

Authors: Patel PN, Most SP. Journal: Facial Plast Surg Clin North Am. 2023 Feb;31(1):1-11. doi: 10.1016/j.fsc.2022.08.003. PMID: 36396280