Push-Down Technique for Revision of Structural Rhinoplasty

The use of let-down and push-down techniques has gained great popularity. In dorsal preservation rhinoplasty, down techniques are used to correct the dorsal hump with resections from the septum while preserving the anatomic integrity of the dorsum. In this study, the authors used the push-down technique in revision rhinoplasty for patients who had previously undergone structural rhinoplasty.

Twelve patients who underwent revision rhinoplasty with push-down technique to correct the supratip deformity or reduce the dorsal height were included in this retrospective study. Complete mobilization of the cartilaginous septum and low septal excision were performed in all patients. Evaluations were made using standardized preoperative and postoperative (1 and 6 month) front and lateral-view photographs by 2 plastic surgeons. The Rhinoplasty Outcome Evaluation scale was applied at 6 months.

The goal of correcting the supratip deformity or reducing the dorsal height was achieved in all patients. Eleven patients (91.6%) were satisfied according to ROE scores. Marked improvements were achieved in the evaluation of plastic surgeons. There were no complications.

Push-down technique can be used effectively in secondary rhinoplasty. This approach avoids technical difficulties and potential complications associated with re-disruption and restoration of the previously reconstructed dorsum.