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Published on: June 20, 2018
Clarification and Classification of Dorsal Preservation Rhinoplasty: Lessons from a Continuous 1,191-Case Experience
Yves Saban1, Neil S Sachanandani2
1. Department of Facial Plastic Surgery and Rhinoplasty, Clinique Kantys, Nice Centre, Nice, France.
Plastic and Reconstructive Surgery
|July 17, 2026
Summary
Dorsal preservation rhinoplasty (DPR) evolved through distinct phases, with a unified framework significantly reducing revision rates. This approach clarifies techniques and establishes DPR as a reliable surgical method.
Area of Science:
- Plastic Surgery
- Otolaryngology
- Facial Plastic Surgery
Background:
- Dorsal preservation rhinoplasty (DPR) lacks a unified framework, leading to confusion in techniques, indications, and outcomes.
- Diverse techniques and terminology hinder standardized understanding and application of DPR.
Purpose of the Study:
- To analyze the evolution of dorsal preservation rhinoplasty (DPR) over time.
- To evaluate the impact of a unified conceptual framework on DPR outcomes and revision rates.
- To establish a standardized methodology and classification for DPR.
Main Methods:
- Retrospective review of 1,191 primary rhinoplasties performed by a single surgeon (2010-2024).
- Analysis of three chronological series (Series 1: 2010-2014, Series 2: 2015-2019, Series 3: 2020-2024).
- Comparison of revision rates and clinical lessons across series, with Series 3 applying a unified framework.
Main Results:
- Revision rates were 3.4% (Series 1), 9.9% (Series 2), and 3.3% (Series 3), showing significant differences (p < 0.001).
- The unified framework in Series 3 led to reliable outcomes and minimized revisions.
- A pyramidal classification with septoplasty modulators was developed.
Conclusions:
- Dorsal preservation rhinoplasty (DPR) follows a U-shaped learning curve: initial concept, expansion, and consolidation.
- Integration of a pyramidal framework and W-point septoplasty standardizes DPR methodology and terminology.
- DPR is established as a reproducible and mature approach in modern surgical practice.
