Reducing Dorsal Hump Recurrence Following Push Down-Let Down Rhinoplasty

Area of Science:

• Plastic Surgery
• Otolaryngology
• Facial Plastic Surgery

Background:

• Hump recurrence is a frequent complication in dorsal preservation (DP) rhinoplasty, particularly during surgeon training.
• Managing dorsal irregularities post-DP surgery requires understanding various prevention and treatment strategies.

Purpose of the Study:

• To compare different surgical methods for preventing and treating dorsal hump problems after DP rhinoplasty.
• To analyze the correlation between preoperative hump characteristics and postoperative recurrence.

Main Methods:

• A study of 150 primary rhinoplasty patients undergoing DP surgery using either push-down (PD) or let-down (LD) techniques.
• Nose hump classification by shape (V- or S-shaped) and height (<4 mm for PD, >4 mm for LD).
• Follow-up assessments included physical examination and photographs at 1 week, 3 months, and 12 months.

Main Results:

• A total of 150 patients were analyzed with a mean follow-up of 12.68 months.
• Eight patients (5.3%) experienced visible dorsal hump recurrence, all with preoperative humps >4 mm.
• Revision surgeries included PD, LD, and open resection rhinoplasty.

Conclusions:

• Preoperative hump height is significantly correlated with the likelihood of hump recurrence after DP rhinoplasty.
• Implementing specific technical maneuvers and careful patient selection can lower the complication rate.