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Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation

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Preservation Rhinoplasty in Contemporary Practice: Integrating Structural and Tissue-Sparing Techniques Along a

Ronald M Cornely¹, Erin N Abbott¹, Nomongo Drjsuren²

¹From the Vanderbilt University Medical Center, Department of Plastic Surgery, Nashville, TN.

Annals of Plastic Surgery

|June 26, 2026

Summary

Preservation rhinoplasty (PR) offers a modern approach to nasal surgery, focusing on conserving anatomy for better functional and aesthetic results. This technique is effective and safe, complementing traditional methods for personalized patient outcomes.

Keywords:

alar preservation dorsal preservation hybrid preservation preservation rhinoplasty septal management

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Area of Science:

Plastic Surgery
Otolaryngology

Background:

Preservation rhinoplasty (PR) is a modern surgical philosophy emphasizing conservation of native nasal structures.
It is increasingly viewed as a continuum with structural rhinoplasty, allowing for hybrid, anatomy-guided approaches.

Purpose of the Study:

To review the evolution, principles, and techniques of preservation rhinoplasty.
To discuss patient selection, outcomes, and potential complications.

Main Methods:

Comprehensive literature review focusing on dorsal preservation, septal and tip management, and alar preservation.
Discussion of powered instrumentation, preoperative imaging, and surgical approaches.

Main Results:

PR is a safe and effective technique yielding favorable aesthetic and functional outcomes.
Comparative studies suggest PR achieves results comparable or superior to traditional methods in select patients.
Potential limitations include dorsal hump recurrence and internal nasal valve narrowing.

Conclusions:

Preservation rhinoplasty is a valuable addition to surgical techniques, complementing structural approaches.
It allows for individualized, anatomy-based surgical planning and execution.
Surgeons are encouraged to adopt PR principles for enhanced functional and stable rhinoplasty outcomes.