(0529) Preservation Rhinoplasty: A Consideration for Asian Patients

Introduction: Preservation rhinoplasty has emerged as an innovative surgical technique designed to safeguard the nasal dorsum. Due to anatomical disparities, the concept of preservation rhinoplasty necessitates reconsideration when applied to Asian patients.

Methods: In a retrospective analysis, we scrutinized 15 patients who underwent primary preservation rhinoplasty for hump nose correction. The surgery occurred between October 2020 to January 2024. Preoperative and postoperative evaluations included a review of medical charts, subjective questionnaires, as well as examination of external photographs. Anthropometric variables, including nasofrontal angle, nasolabial angle, radix height, relative hump height, and tip projection length were also measured.
All surgeries were executed using an open approach under general anesthesia. Bone work involved push-down (n=10) and let-down (n=5) procedures. Septum work included high septal strip removal (n=6), subdorsal Z flap (n=5), and Tetris technique (n=4). Radix augmentation and tip modification were performed on all patients. 12 patients with septal deviation and 5 patients with external deviation were enrolled.

Results: Analysis of preoperative and postoperative of the Sinonasal Outcome test-22 revealed 46.8 ± 23.4 (mean ± standard deviation) and 8.4 ± 8.7, respectively. Similarly, the Standardized Cosmesis and Health Nasal Outcomes Survey scores showed a preoperative value of 33.5 ± 8.9 and a postoperative value of 3.5 ± 3.7. Anthropometric measurements indicated significant changes in most angles and notable alteration in hump heights (the relative hump height and the radix height: approximately 83% and 57%, respectively). No major complications were observed.

Conclusions: Our findings suggest that dorsal preservation rhinoplasty is an effective surgical technique for Asian hump patients. Emphasis on radix and tip modifications is crucial for successful outcomes in Asian patients. Moreover, individuals with nasal septal deviation or even external deviation might also be suitable candidates for dorsal preservation in Asians.