Exploring the Resurgence of the Preservation Rhinoplasty: A Systematic Literature Review.


Journal

Aesthetic plastic surgery
ISSN: 1432-5241
Titre abrégé: Aesthetic Plast Surg
Pays: United States
ID NLM: 7701756

Informations de publication

Date de publication:
08 2023
Historique:
received: 28 02 2023
accepted: 25 03 2023
medline: 23 10 2023
pubmed: 3 5 2023
entrez: 2 5 2023
Statut: ppublish

Résumé

The underlying principles of preservation rhinoplasty (PR) center around maintaining the soft tissue envelope, dorsum, and alar cartilage through surgical manipulations and tip suture techniques. In particular, the let-down (LD) and push-down (PD) techniques have been described, although reports of indications and outcomes in the literature are sparse. A systematic review of the literature was performed using search terms "preservation" OR "let down" OR "push down" AND "rhinoplasty" on PubMed, Cochrane, SCOPUS, and EMBASE databases. Patient demographic information, operative details, and surgical outcomes were recorded. Sub-cohorts for patients who underwent LD and PD techniques were analyzed utilizing Fischer's exact test for categorical variables and Student's t test for continuous variables. Overall, there were 5967 PR patients in 30 studies in the final analysis, with 307 patients in the PD cohort and 529 patients in the LD cohort. The Rhinoplasty Outcome Evaluation Questionnaire showed a significant increase of patient satisfaction after PR compared to before PR (62.13 vs 91.14; p < 0.001). There was a significantly lower rate of residual dorsal hump or recurrence of 1.3% (n = 4) in the PD when compared to 4.6% (n = 23) in LD cohorts (p = 0.02). The revision rate of PD (0%, n = 0) was also significantly lower than that of LD (5.0%, n = 25) (p < 0.001). Based on these published articles, it seems that preservation rhinoplasty is safe and efficacious procedure with improved dorsal aesthetic lines, reduced dorsal contour irregularities, and claimed excellent patient satisfaction. In particular, the PD technique has fewer reported complications and revisions than LD approach, although PD is often indicated in patients with smaller dorsal humps. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Identifiants

pubmed: 37130993
doi: 10.1007/s00266-023-03345-8
pii: 10.1007/s00266-023-03345-8
doi:

Types de publication

Systematic Review Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1488-1493

Informations de copyright

© 2023. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.

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Auteurs

Michael W Wells (MW)

Case Western Reserve University School of Medicine, Cleveland, OH, USA.

Anthony DeLeonibus (A)

Department of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.

Devin Barzallo (D)

Case Western Reserve University School of Medicine, Cleveland, OH, USA.

Irene A Chang (IA)

Case Western Reserve University School of Medicine, Cleveland, OH, USA.

Marco Swanson (M)

Department of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.

Bahman Guyuron (B)

Case Western Reserve University School of Medicine, Cleveland, OH, USA. bguyuron@guyuron.com.
Zeeba Clinic, 29017 Cedar Road, Lyndhurst, Cleveland, OH, 44124, USA. bguyuron@guyuron.com.

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