Two-Point Fixation in Low-Septal-Resection Dorsal Preservation Rhinoplasty

Fixation of quadrangular septal cartilage is a basic step in low-septal-resection dorsal preservation rhinoplasty. The most commonly used technique for this purpose is the fixation of the septum with a suture to the anterior nasal spine. This study presents the use of a previously described dorsal fixation suture as a second fixation maneuver in addition to anterior nasal spine fixation in low-septal-resection cases.Eighty-six patients who underwent closed-approach low-septal-resection dorsal preservation rhinoplasty between January and December 2022 were included in this retrospective study. Depending on the number of surgical maneuvers performed for stabilization of quadrangular septal cartilage, the patients were divided into two groups as follows: (i) a one-point fixation group in which the septum was fixed only to the anterior nasal spine and (ii) a two-point fixation group in which the septum was fixed to both the anterior nasal spine and the septal mucoperichondrium with dorsal fixation suture. Standardized postoperative 12-month lateral-view photographs were scanned for the presence of hump recurrence. The rhinoplasty outcome evaluation (ROE) scale was applied at 12 months.Hump recurrence was observed in five patients in the one-point fixation group (n = 31) and in one patient in the two-point fixation group (n = 55; p < 0.05). No statistically significant difference was found between the groups (p > 0.05) for the ROE scores and ratio of satisfied patients.The addition of dorsal fixation suture to anterior nasal spine fixation (two-point fixation) may reduce the rate of hump recurrence in low-septal-resection dorsal preservation rhinoplasty. The level of evidence is 4.