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

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