The Cottle Method and Modifications in Preservation Rhinoplasty

Preservation rhinoplasty has gained much popularity in recent years, but represents a fundamental long-standing approach that has been used for generations. We review some of the relevant history of the "Cottle Rhinoplasty technique," as well as a number of modifications we often incorporate into the operation to further improve upon Cottle's original push-down/let-down. Through the modifications we include, which represent techniques borrowed from structural rhinoplasty including spreader grafts and rhinocontouring, we have been able to achieve more predictable results. In this article, we present some of our favorite modifications to the original Cottle technique.