Semi-Let-Down and Semi-Push-Down Preservation Techniques: Maintaining the Intactness of the Distal Region.

Abstract

The nose is an important part of the face and plays a significant role in interpersonal communication and self-esteem. Dorsal preservation techniques, such as the push-down and let-down techniques, are employed for dorsal hump reductions. In this study, several approaches were defined in which the let-down and push-down techniques were applied depending on the patients' needs. The records of 64 patients were assessed retrospectively. The patients who underwent either the push-down or let-down technique for hump reduction and who were eligible for these new approaches were included. In this research, the distal part of the septum remained intact after both the push-down and let-down techniques. Patients were assessed before and 1 year after surgery employing the Rhinoplasty Outcome Evaluation (ROE). The follow-up period ranged from 16 to 25 months (median of 19.2 months). The median ROE score before surgery was 61.6 (minimum: 58; maximum: 64) and increased to 92.2 (minimum: 82; maximum: 96) points 12 months after surgery. This increase in the ROE score was statistically significant (P < 0.001). The excellent satisfaction rate was 93.75% according to the ROE scale. These approaches for the let-down and push-down techniques will lead to better results and present different choices to surgeons. The present study is also the first to the author's knowledge to demonstrate leaving behind an intact area of the distal septum in the push-down and let-down techniques.