Dorsal Preservation Rhinoplasty: A Literature Review

Abstract

Acceptance of the preservation principle in rhinoplasty surgery has increased dramatically, and surgeons worldwide are now performing preservation rhinoplasty, leading to an expanding list of indications and techniques. Rhinoplasty surgeons are increasingly opting for rhinoplasty preservation because of its conservative approach and more predictable outcome. This review aims to evaluate the efficacy of dorsal preservation rhinoplasty, as well as the techniques, indications, surgical protocols, complications, and any practical challenges associated with this type of rhinoplasty. A number of medical databases, including Medline-PubMed, Embase, and Scopus, were searched. These searches were supplemented with a manual search using the keyword “preservation rhinoplasty” (PR) during the 1970 to May 2020 time span. The search strategy was limited to case reports, randomized clinical trials, and prospective studies of preservation dorsal rhinoplasty in journals published in English. A total of 150 articles that incorporated preservation dorsal rhinoplasty as a newer surgical technique were reviewed: 136 from PubMed, 17 experimental studies from Embase, 17 clinical studies from Scopus, and 8 studies identified by data extraction. Preservation rhinoplasty represents a paradigm shift in rhinoplasty philosophy. While techniques continue to improve, the philosophy remains the same: preserving and reshaping the existing nasal structures. Although not all patients benefit from and are satisfied with PR and some may only benefit from partial PR, preserving the anatomy allows for a more intuitive operation and natural results. For a more exhaustive review, readers are encouraged to turn their attention to dorsal preservation as a versatile and adaptable technique. Dorsal preservation avoids long-term issues with the middle vault and keystone area, and the patient benefits from total preservation, as the underlying structure can be reshaped without disruption.