Our Summary

This research paper discusses preservation rhinoplasty, a hot topic in the field of nose surgery. It explains that there’s no one-size-fits-all technique that can fix every issue with the nose, so understanding each patient’s unique situation is vital. The paper specifically looks at the anatomy of a central area of the nose and how this area behaves, using the concept of biotensegrity (the way biological structures balance tension and compression forces).

It also compares two surgical techniques: the push-down and let-down methods, specifically in relation to how they affect the nasal valve (a key part of the nose that controls airflow). The let-down technique is highlighted as it keeps the natural balance of the nose structure.

The paper concludes that in most cases, it’s better to try and preserve the existing structure of the nose rather than removing parts of it, and repositioning elements is preferable over manipulating them.

FAQs

  1. What is preservation rhinoplasty and how does it differ from traditional techniques?
  2. How does the ’let-down’ technique in rhinoplasty maintain the tensegrity of the nasal pyramid?
  3. What is the significance of the keystone area in understanding the dynamics of the dorsum in rhinoplasty?

Doctor’s Tip

A helpful tip a doctor might tell a patient about rhinoplasty is to prioritize preservation over resection and reposition over manipulation. It is important to analyze each patient’s anatomy and choose the technique that will maintain the tensegrity of the nasal pyramid for the best results. It is also important to understand the differences between push-down and let-down techniques, with the let-down technique often being preferred to preserve the natural structure of the nose.

Suitable For

Patients who are typically recommended for rhinoplasty include those who are unhappy with the size, shape, or overall appearance of their nose. This could include individuals with a bump on the bridge of the nose, a crooked nose, a drooping or bulbous tip, or breathing difficulties due to structural issues within the nose. Patients should be in good overall health and have realistic expectations for the outcome of the surgery. It is important for patients to undergo a thorough consultation with a board-certified plastic surgeon to determine if they are a good candidate for rhinoplasty.

Timeline

Before Rhinoplasty:

  • Patient meets with a plastic surgeon to discuss goals and expectations for the procedure
  • Surgeon evaluates the patient’s nasal anatomy and discusses potential surgical techniques
  • Pre-operative tests and evaluations are conducted to ensure the patient is a suitable candidate for rhinoplasty
  • Patient receives instructions on how to prepare for surgery, including avoiding certain medications and foods

After Rhinoplasty:

  • Patient undergoes the rhinoplasty procedure under anesthesia
  • Recovery period begins, with swelling, bruising, and discomfort expected in the days following surgery
  • Patient may need to wear a splint on the nose for a week or more to protect the newly shaped nasal structures
  • Follow-up appointments with the surgeon are scheduled to monitor healing and address any concerns
  • Over the following weeks and months, swelling gradually subsides and the final results of the rhinoplasty become apparent.

What to Ask Your Doctor

  1. What are the risks and potential complications of rhinoplasty?
  2. What is the recovery process like after rhinoplasty surgery?
  3. How long will it take to see the final results of the rhinoplasty procedure?
  4. Can you show me before and after photos of patients who have had similar rhinoplasty procedures?
  5. What is your experience and expertise in performing preservation rhinoplasty?
  6. How will my breathing be affected after rhinoplasty, especially if I have concerns about my nasal valve function?
  7. Can you explain the differences between the push-down and let-down techniques in rhinoplasty and why one may be more suitable for me?
  8. How will the preservation rhinoplasty technique maintain the natural structure and aesthetics of my nose?
  9. What type of anesthesia will be used during the rhinoplasty procedure?
  10. Are there any specific post-operative care instructions I should follow to ensure optimal results?

Reference

Authors: Montes-Bracchini JJ. Journal: Facial Plast Surg Clin North Am. 2021 Feb;29(1):59-66. doi: 10.1016/j.fsc.2020.09.006. PMID: 33220844