Preservation rhinoplasty is a concept that has recently become popular in the world of facial plastic surgery. It involves less invasive techniques that preserve the structure of the nose when this is possible. The methods used were developed many years ago by many of the pioneers of rhinoplasty surgery. However, with the advent of open structure rhinoplasty, many of these techniques were forgotten or replaced by more aggressive surgery.
Over the last several years, surgeons in Europe, Turkey, South America and Mexico have made important modifications and brought these less invasive techniques back into practice.
Dr. Rival is one of only a handful of surgeons in the United States and Canada who use these techniques.
How it Works
One of the most common reasons patients come in for a rhinoplasty procedure is to fix a hump or for hump reduction on the nose. In a standard reduction rhinoplasty, the hump is removed or shaved down, and the surgeon will reconstruct to create a more attractive bridge from the front. In dorsal preservation rhinoplasty, the surgeon will remove cartilage pieces or bone from below the dorsal hump and the septum’s top or bottom; this allows the bridge to be “let down” instead of removing the hump from above. As a result, this produces a very smooth, natural nasal bridge with a lower incidence of bumps or depressions.
In the nasal tip, preservation rhinoplasty concepts involve preserving and reshaping the tip cartilages and maintaining or repairing the nasal ligaments that attach the skin to the cartilages. In some cases, the nasal skin may not have to be lifted, leading to far less bruising and swelling. A top facial plastic surgeon can perform preservation rhinoplasty techniques through an open approach or closed approach.
Who is a Good Candidate for Preservation Rhinoplasty
Preservation rhinoplasty is an excellent solution for patients with a crooked nose and patients with a wide or droopy tip. It is best in patients with an attractive nasal bridge from the front view but dislikes their bridge’s prominence from the side view. We don’t recommend this procedure for patients with an irregular, asymmetric or wide nasal bridge or those who previously had rhinoplasty.
To determine whether it’s right for you or your specific goals and aesthetics, you must consult with an experienced rhinoplasty surgeon. In the meantime, here, we explore the pros and cons of preservation rhinoplasty.
The Benefits
Despite the less-invasive elements of preservation rhinoplasty vs traditional reduction rhinoplasty, we are still studying all of the benefits in full detail. It appears that the results produce a smoother natural-appearing nasal bridge. The amount of swelling and healing time for a patient seems to reduce significantly compared to structure rhinoplasty.
While not yet proven, it seems that removing less of the nose structure helps to maintain proper nose function better. We hope that there is less risk of blocking airways or structural problems occurring with age.
Should a patient ever need revision rhinoplasty, their chances of better recovery and better results improve since more tissue, cartilage, and structure remain in place. A surgeon is less limited in their revision options. The more that is missing, the less the surgeon can adjust.
The Cons
Preservation rhinoplasty is not for everybody. More complex nasal deformities will require traditional structural techniques to get the best results and may not suit patients with very thick skin and soft tissue or cartilage. In some cases, we use a combined approach to preserve the bridge but use structural techniques in the nasal tip.
As well, preservation rhinoplasty is usually only suitable for a “first-time” patient. When seeking revision rhinoplasty, you likely will need to go the traditional route. The initial nose job may have reduced the available cartilage and nose structure; as such, preservation may be more limited in what rhinoplasty can do.
Discover if Preservation Rhinoplasty is Right for You
Dr. Richard Rival is double board-certified in Otolaryngologist Head and Neck Surgeon practicing in Facial Plastic Surgery exclusively. He can help you understand whether traditional or preservation rhinoplasty is the right solution to achieve your goals, as well as help you consider other facial surgery procedures that may be cosmetic or functional.
Book your rhinoplasty consultation in Toronto.