Dorsal modification: Practical applications in rhinoplasty.

Abstract

Management of the dorsum continues to present challenges for rhinoplasty surgeons, especially regarding the inherent asymmetry of the bony and cartilaginous vaults and the need for a highly individualized approach for each case. This study presents the author's current operative technique for dorsal modification that can be effectively used as independent approach to improve the shape of the dorsum and its symmetry in cases where there is no need to significantly change dorsal dimensions (height and width). The aim of this study was to assess the efficiency of dorsal modification for treatment of the dorsum. Authors described a technique that involves only superficial work with the dorsum, without resecting/reconstructing its main parts that support and ensure dorsal stability. One hundred forty-seven patients who underwent dorsal modification technique between October 2020 and March 2024 were retrospectively reviewed. A step-by-step algorithm was applied to achieve the required dorsal improvement. The average postoperative follow-up period was 27 months (range, 12-41 months). No patients required revision surgery of their dorsum. No complications were reported. A retrospective analysis on 147 patients demonstrated aesthetic and functional improvement. Dorsal modification as a separate philosophy is a very conservative, fast and reliable approach. In cases where there is no need to significantly change dorsal dimensions (height and width), dorsal modification improves the dorsum as quickly and efficiently as possible without significant structural resection and no reconstruction, while maintaining stability and maximum predictability.