53 clinical terms covering preservation rhinoplasty technique, anatomy, deformities, and credentials. Cross-referenced throughout the site for context-driven learning.
A philosophical and technical approach to rhinoplasty that maintains the natural dorsal aesthetic line, the keystone area, and the upper lateral cartilages instead of disrupting them. Achieved primarily through push-down or let-down techniques. Distinguished from structural (component reduction) rhinoplasty by preservation rather than reconstruction of the middle vault.
The traditional rhinoplasty approach in which the dorsal hump is reduced by sequential excision of bony cap and cartilaginous middle vault, then the resulting open roof is closed by lateral osteotomies and middle vault is reconstructed via spreader grafts. Workhorse approach for large humps and complex anatomy.
Preservation rhinoplasty technique in which a sub-dorsal septal strip is removed and the lateral nasal walls are mobilised through high lateral osteotomies, allowing the entire dorsal segment (skin, ULC, dorsal septum, bony cap) to be pushed inferiorly into the resected septal space. Suitable for mild-to-moderate humps.
Variation of preservation rhinoplasty similar to push-down but with bony resection at the base of the lateral nasal wall (a wedge of bone is removed). The entire dorsum 'lets down' into the deeper plane via the bony resection. Suitable for moderate-to-large humps that exceed push-down's range.
In preservation rhinoplasty, the strip of septum removed is taken from the lower (caudal) portion of the dorsal septum. Allows the dorsum to descend into the created space. Distinguished from high septal resection by anatomic location of the resection.
Alternative preservation technique in which the septal strip is removed from the upper portion of the dorsal septum. Different mechanical effect on dorsal descent; specific indications based on anatomy.
Atraumatic non-reductive dorsal aesthetic rhinoplasty. A specific preservation rhinoplasty modification emphasising atraumatic technique and minimal disruption of the soft tissue envelope. Contributes to faster recovery and reduced post-op edema.
Specific preservation rhinoplasty modification developed by Rollin Daniel and Peter Palhazi, building on Cottle's original push-down concept. Addresses limitations of pure push-down with specific osteotomy and septal modifications.
Surgeon-specific variations of preservation rhinoplasty technique developed by Joaquim Ishida and Yves Saban respectively. Refinements emphasising specific osteotomy patterns, septal handling, and dorsal mobilisation strategies.
Preservation rhinoplasty modification developed by Aleksandar Kovacevic, refining bony pyramid handling and lateral wall mobilisation.
The paired curvilinear shadows that travel from the medial brow, through the keystone area, down the dorsum, and into the tip-defining points. Not a structure but the visible result of underlying anatomy combining into a continuous light reflex. Smooth, parallel dorsal aesthetic lines are the most important single aesthetic target in rhinoplasty.
The junction of the bony pyramid (nasal bones), the dorsal septum, and the upper lateral cartilages. The 'keystone' of the nasal architecture — the intersection where bony and cartilaginous segments meet. Preservation of this junction is a defining principle of preservation rhinoplasty.
The segment of the nose between the bony pyramid (upper third) and the lower lateral cartilages (tip). Comprises dorsal septum centrally and upper lateral cartilages laterally. Most fragile segment of nasal architecture; commonly disrupted in structural rhinoplasty.
Paired cartilages that form the lateral walls of the middle vault, articulating with the dorsal septum centrally and the nasal bones cephalically. Preservation of ULC integrity is a defining feature of preservation rhinoplasty.
Paired cartilages that form the structural support of the nasal tip. Comprises medial crura, intermediate crura (dome), and lateral crura. Tip-defining points are formed at the dome.
Visible aesthetic complication where the lower edge of the nasal bones becomes prominent because the underlying upper lateral cartilages have collapsed inward — typically after structural rhinoplasty without adequate middle vault support. Creates an upside-down V shape at the keystone area. Most common cause of broken dorsal aesthetic lines.
Visible aesthetic complication where the supratip area (just above the tip) appears fuller than the surrounding dorsum, creating a parrot-beak profile. Causes: inadequate dorsal reduction, scar tissue accumulation in supratip, over-rotation of the tip without adequate dorsal reduction.
Significant dorsal depression caused by over-resection, septal collapse, or trauma. Creates a 'saddle' appearance on profile. Reconstruction typically requires dorsal augmentation with cartilage or bone graft.
Small concavity above the tip on profile view. A defined supratip break is a feminine aesthetic feature; absent or minimal in masculine aesthetic targets.
The angle formed between the upper lip and the columella (vertical strip between nostrils) on profile view. Masculine target: 90-95° (perpendicular). Feminine target: 95-110° (slightly upturned).
The angle formed between the forehead and the dorsum at the radix. Masculine target: 130-140° (more obtuse). Feminine target: 115-130° (more acute, deeper radix).
The deepest point of the nasal root, between the eyes. Anatomically, the nasofrontal suture region. In masculine aesthetics, a shallow radix is desired; in feminine aesthetics, a deeper radix is acceptable. Preservation of radix depth is a key principle in male and ethnic rhinoplasty.
The two points of maximum projection at the dome of the lower lateral cartilages. Visible as light reflex on the tip. Subtle definition (single broad reflex) is masculine; sharper definition (two distinct points) is feminine.
Tip projection measurement: ratio of the distance from alar crease to tip versus distance from alar crease to nasion. Goode's ideal: 0.55-0.6. Used to assess and plan tip projection.
Cartilage strip placed between the dorsal septum and the upper lateral cartilage to support the middle vault. Routine in structural rhinoplasty after hump reduction; not needed in preservation rhinoplasty when middle vault is preserved intact.
Folded upper lateral cartilage used as a spreader instead of a separate cartilage graft. Achieves similar middle vault support using the patient's own tissue without need for graft harvest.
Preserved cartilaginous portion of the resected dorsal hump folded laterally to form spreader grafts. Combines benefits of spreader grafts with no separate donor site requirement.
Cartilage graft placed between the medial crura of the lower lateral cartilages to support tip projection. Routine in tip refinement work to prevent post-op tip drop.
Cartilage graft attached to the caudal septum to project and support the tip. Used to increase tip projection or correct retracted columella.
Cartilage graft placed laterally to support the alar rim and prevent or correct external nasal valve collapse. Routine in functional rhinoplasty for valve repair.
The angle between the upper lateral cartilage and the septum. The narrowest point of the nasal airway in normal anatomy. Pathologically narrow valves are a major airway obstruction site.
The most lateral airway segment, formed by the alar rim and lateral crus. Collapse during inspiration narrows the valve.
Surgical correction of septal deviation. Often combined with rhinoplasty as septorhinoplasty. The septum is the central support of the nose; aesthetic and functional outcomes share the same anatomy.
Combined operation addressing both functional (breathing — septoplasty component) and aesthetic (shape — rhinoplasty component) concerns. Modern practice treats them as one operation rather than two separate procedures.
Surgical reduction of the inferior turbinate to improve nasal airflow. Performed via various techniques (radiofrequency, submucosal, surgical excision). Often combined with septoplasty.
Surgical cut in bone. In rhinoplasty, lateral osteotomies are made to mobilise the nasal bones and close the open roof after hump reduction. Preservation rhinoplasty uses different osteotomy patterns to mobilise the entire bony pyramid downward.
Osteotomy at the lateral wall of the nasal pyramid. In structural rhinoplasty, used to close open roof after hump reduction. In preservation rhinoplasty (let-down), used to remove a wedge of bone allowing dorsal descent.
Osteotomy at the medial junction of the nasal bones with the perpendicular plate of the ethmoid. Combined with lateral osteotomy to fully mobilise the bony pyramid.
Horizontal osteotomy connecting the lateral and medial osteotomies. Allows full mobilisation of the bony pyramid in preservation rhinoplasty.
Ultrasonic instrument that cuts bone selectively without damaging adjacent soft tissue. Increasingly used in preservation rhinoplasty for precise osteotomies and bony cap reduction with reduced ecchymosis.
Connective tissue layer in the nasal anatomy. Different from the abdominal Scarpa fascia. In rhinoplasty, refers to fascial layers preserved during dissection to maintain vascularity and reduce post-op edema.
Superficial musculoaponeurotic system of the nose. Connective tissue layer between skin and underlying cartilage/bone. Sometimes selectively thinned in thick-skinned patients to improve definition.
Steroid injection (triamcinolone acetonide) used post-operatively for persistent supratip swelling, particularly in thick-skinned patients. Diluted to 10 mg/mL, injected into subcutaneous tissue. Properly used, accelerates resolution; improperly used, creates skin atrophy.
Validated patient-reported outcome measure for facial aesthetic surgery, including rhinoplasty. Quantifies satisfaction with appearance, social functioning, and quality of life. Routine collection in higher-quality practices at pre-op and follow-up timepoints.
Re-operation to correct unsatisfactory results from prior rhinoplasty. Rate 5-15% across published series. Technically more demanding than primary surgery — scarred dissection planes, depleted cartilage budget, altered anatomy. Wait minimum 12 months from primary surgery.
Rhinoplasty in patients of non-Northern-European heritage where the standard 'idealised' aesthetic targets do not apply. Mediterranean, Middle Eastern, South Asian, East Asian, African heritage all have specific aesthetic considerations and skin/cartilage characteristics. Preservation rhinoplasty is often well-suited because it maintains ethnic-specific dorsal anatomy.
Rhinoplasty in patients with thicker nasal skin (common in Mediterranean, Middle Eastern, South Asian, African heritage). Skin obscures the underlying cartilage framework — refinement maneuvers softer than in thin skin. Requires strong structural framework, conservative refinement, and longer recovery for definition emergence.
Rhinoplasty performed entirely through internal nasal incisions, without external transcolumellar incision. Compatible with preservation rhinoplasty. Advantages: no external scar, faster swelling resolution. Limitations: less visualisation for complex cases.
Rhinoplasty performed through a transcolumellar incision combined with internal incisions. Provides extensive visualisation. Standard for complex revision, severe asymmetry, complex tip work.
Senior surgical credential awarded by the American College of Surgeons. Requires national specialty certification, evidence of practice quality, peer recommendations, and ethical standards. Open to surgeons internationally. Verifiable at facs.org Fellow lookup.
Fellow, European Board of Plastic, Reconstructive and Aesthetic Surgery. European-level board certification beyond national specialty certification, examination-based. Verifiable at ebopras.eu.
Largest international aesthetic plastic surgery society. ISAPS membership requires peer recognition and ethical standards. ISAPS World Congress is the largest international aesthetic plastic surgery conference. Verifiable at isaps.org.
International gold standard for hospital accreditation. Certifies the hospital meets specific standards across patient safety, infection control, medication management, surgical care, and quality monitoring. Multi-year compliance with hundreds of specific standards; renewed every 3 years through external audit.
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