Combination of the Push-Down and Let-Down Techniques: Mix-Down Approaches

Abstract

Rhinoplasty is one of the most widely conducted and challenging types of aesthetic surgical operations, and dorsal hump reduction is a commonly performed aesthetic surgery among Caucasian patients. Dorsal hump resection is traditionally conducted by removing the dorsal nasal bone and cartilage. The push-down and let-down techniques are used for dorsal preservation in dorsal hump reduction operations. Different patients require different approaches to achieve the best results in terms of aesthetic appearance and functionality. In the present research, the author describes two novel approaches that combine the push-down and let-down techniques for appropriate patients. The records of 45 patients (40 females and 5 males) were assessed, and those who were eligible for the present approaches were included. The author defined two approaches in which the push-down and let-down techniques were used simultaneously (mix-down methods). All patients included in the study completed the Rhinoplasty Outcome Evaluation (ROE) questionnaire before surgery and at their one-year follow-up appointment. The median ROE scores were 60.1 points before surgery and 92.2 points one year after surgery; this difference was statistically significant (p<0.001). The present study is the first to demonstrate the beneficial effects of combining the push-down and let-down techniques in a selected patient population. These new approaches will improve both cosmetic and functional outcomes and allow surgeons to choose the best option for patients who are eligible for these mix-down approaches. 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 .