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Aesthetic Plastic Surgery

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02.05.2023 | Review

Exploring the Resurgence of the Preservation Rhinoplasty: A Systematic Literature Review

verfasst von: Michael W. Wells, Anthony DeLeonibus, Devin Barzallo, Irene A. Chang, Marco Swanson, Bahman Guyuron

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 4/2023

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Abstract

Introduction

The underlying principles of preservation rhinoplasty (PR) center around maintaining the soft tissue envelope, dorsum, and alar cartilage through surgical manipulations and tip suture techniques. In particular, the let-down (LD) and push-down (PD) techniques have been described, although reports of indications and outcomes in the literature are sparse.

Methods

A systematic review of the literature was performed using search terms “preservation” OR “let down” OR “push down” AND “rhinoplasty” on PubMed, Cochrane, SCOPUS, and EMBASE databases. Patient demographic information, operative details, and surgical outcomes were recorded. Sub-cohorts for patients who underwent LD and PD techniques were analyzed utilizing Fischer’s exact test for categorical variables and Student’s t test for continuous variables.

Results

Overall, there were 5967 PR patients in 30 studies in the final analysis, with 307 patients in the PD cohort and 529 patients in the LD cohort. The Rhinoplasty Outcome Evaluation Questionnaire showed a significant increase of patient satisfaction after PR compared to before PR (62.13 vs 91.14; p < 0.001). There was a significantly lower rate of residual dorsal hump or recurrence of 1.3% (n = 4) in the PD when compared to 4.6% (n = 23) in LD cohorts (p = 0.02). The revision rate of PD (0%, n = 0) was also significantly lower than that of LD (5.0%, n = 25) (p < 0.001).

Conclusion

Based on these published articles, it seems that preservation rhinoplasty is safe and efficacious procedure with improved dorsal aesthetic lines, reduced dorsal contour irregularities, and claimed excellent patient satisfaction. In particular, the PD technique has fewer reported complications and revisions than LD approach, although PD is often indicated in patients with smaller dorsal humps.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Titel: Exploring the Resurgence of the Preservation Rhinoplasty: A Systematic Literature Review
verfasst von: Michael W. Wells
Anthony DeLeonibus
Devin Barzallo
Irene A. Chang
Marco Swanson
Bahman Guyuron
Publikationsdatum: 02.05.2023
Verlag: Springer US
Erschienen in: Aesthetic Plastic Surgery / Ausgabe 4/2023
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI: https://doi.org/10.1007/s00266-023-03345-8

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Exploring the Resurgence of the Preservation Rhinoplasty: A Systematic Literature Review