High vs Low Septal Preservation Rhinoplasty: A Quantitative Morphologic Analysis of Hump-Supratip Dynamics

Preservation rhinoplasty is gaining attention for achieving natural dorsal contours. High septal and low septal approaches are two main variants, yet comparative clinical data remain limited.

To quantitatively compare high septal and low septal preservation rhinoplasty using a standardized supratip and dorsal hump measurement method and to evaluate their relationship with technique-related biomechanical behavior and dorsal contour changes.

Thirty patients who underwent preservation rhinoplasty between 2022 and 2024 were retrospectively reviewed and categorized by technique (high septal vs. low septal). Uniform lateral photographs were analyzed to quantify hump and supratip heights. Four parameters were used to compare supratip and hump reduction between approaches and within each technique, including angular measurements. Statistical analyses included Mann-Whitney U tests, t tests, descriptive statistics and ANCOVA.

The first two parameters demonstrated statistically significant differences in supratip descent between techniques, with greater lowering in the high septal group and a relatively higher supratip position in the low septal group. The third parameter showed divergent responses: supratip change diminished with greater hump reduction in the high septal group but increased in the low septal group. The fourth parameter captured supratip-hump behavior in angular form, with higher values in the low septal group and lower values in the high septal group.

This study provides an objective anthropometric comparison of high septal and low septal preservation rhinoplasty techniques and demonstrates differing proportional supratip responses between approaches. These findings may improve understanding of technique-related dorsal contour behavior and assist surgical planning.

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