What is “preservation rhinoplasty”? What is S.M.A.R.T rhinoplasty?

Preservation rhinoplasty consists of remodelling the existing anatomy of
the nose, using very few tissue resections and often no grafts to achieve a
more natural appearance of your nose without destabilising the nose.  These latest techniques keep the patient’s
natural bridge but find ways to convert a hump into a straight or concave nose
and reshape the cartilage to create a pretty nose without compromising function
or support.  The result is a patient achieving
a natural look that isn’t disfigured or dysfunctional with the goal that fewer
patients will require secondary or tertiary surgery.

Hello and thank you for your question. This refers to preserving the structural cartilaginous foundation of the nose.  This can be done to improve the overall stability of the nose.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system.  You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon.  If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon.

Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

Hi,Closed rhinoplasty "preserves" or more appropriately "does not disturb" more of the supporting structures of the nose. It is important to know that during an open rhinoplasty, the nose is essentially reconstructed with supporting grafts and suturing, so when done properly, nasal support or specifically tip support is not an issue. Don't get bogged down with specific terms, etc. A rhinoplasty expert will be able to give you the nose you want using the most appropriate technique necessary.Best, 

Hello and thank you for your question.
Based on the answers in this thread, I think that most surgeons in the US are not familiar with what true preservation rhinoplasty is. Dr. Badia who is in the UK does know very well. Preservation Rhinoplasty preserves the natural dorsum of the nose. Typically it is rasped, shaved, cut down to create a smooth straight dorsum to the nose. After excision of the dorsum, typically grafts need to be placed and the dorsum reconstructed. Sometimes, particularly in thin skinned patients, if the dorsum isn't meticulously reconstructed, abnormalities can be seen down the road when the swelling is gone. This is not the case with preservation because the natural dorsum remains intact and tissue is removed from below.  Then the natural dorsum is set back/lowered down. The need for numerous grafts is also minimized. Very few surgeons in the U.S. perform this technique. I am one of the few that do so I can tell you first hand that it produces the most natural results when used in properly selected patients. Hope this helps. 

 The general theme is to preserve as much of the cartilage structure of the nose. For example, r-purposing the cartilaginous dorsal hump as spreader grafts. Suture techniques applied to the lower lateral cartilages of the nasal tip are usually performed to reduce and refine the bulbous nasal tip itself. For many examples of  rhinoplasty, please see the link and the video below to our closed rhinoplasty photo gallery