https://orcid.org/0000-0001-9767-7250
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Jamil Ahmad, Commentary on: Decision Making in Preservation Rhinoplasty: A 100 Case Series With One-Year Follow-Up, Aesthetic Surgery Journal, Volume 40, Issue 1, January 2020, Pages 49–52, https://doi.org/10.1093/asj/sjz257
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It is with great pleasure that I discuss “Decision Making in Preservation Rhinoplasty: A 100 Case Series With One-Year Follow-Up” by Drs Kosins and Daniel.1 In this article, Drs Kosins and Daniel review the lead author’s early experience with preservation rhinoplasty in 100 patients.
Preservation rhinoplasty is a term coined by Daniel2 describing an approach to rhinoplasty with the fundamental goals of replacing resection with preservation, excision with manipulation, and secondary rib reconstruction with minimal revisions. In this article, the authors further describe preservation rhinoplasty as a fundamental change in philosophy from structural rhinoplasty with the concept being to preserve and reshape as opposed to reduce and rebuild; if anatomy is preserved less structural rebuilding is necessary. They concisely classify the preservation rhinoplasty approach into 3 distinct components:
In this study, patients were classified into either complete (PR-C) or partial (PR-P) preservation rhinoplasty. PR-C patients had all 3 components above performed whereas PR-P only had 1 or 2 components performed. Of the 100 patients included in the study, all preservation rhinoplasties were performed through the open approach, and 24 patients had PR-C while 76 patients had some variation of PR-P. All 100 patients had preservation of the dorsal soft tissue envelope. Preservation of the alar cartilages was the most commonly performed component (54 patients) followed by preservation of the soft tissue envelope (36 patients) and then preservation of the dorsum (31 patients). There was 1 infection, and the revision rate was 3% with an average follow-up time of 13 months.
