On the "let-down" procedure in septorhinoplasty

Area of Science:

• Plastic Surgery
• Otolaryngology
• Facial Plastic Surgery

Background:

• Septorhinoplasty aims to correct both functional and aesthetic nasal issues.
• Classical techniques may have limitations in specific reconstructive scenarios.

Purpose of the Study:

• To explore the synergistic potential of modified and Cottle's techniques in septorhinoplasty.
• To detail the applications and advantages of combined "let-down" and "push-down" (LD/PD) procedures.

Main Methods:

• Integration of Cottle's maxilla-premaxilla approach with modified septorhinoplasty techniques.
• Application of combined LD/PD maneuvers for nasal dorsum modification.

Main Results:

• LD/PD procedures are advantageous for lowering prominent nasal pyramids while preserving dorsal profile.
• These techniques effectively address residual dorsal prominence after initial rasping.
• LD/PD aids in equalizing deviated bony vaults and removing cartilaginous humps.
• Preservation of upper lateral cartilage integrity is maintained during hump elimination.
• Septum excisions are crucial for facilitating LD/PD maneuvers.

Conclusions:

• The combination of modified and Cottle's techniques offers a versatile approach in septorhinoplasty.
• Combined LD/PD procedures provide specific benefits for complex nasal dorsum reconstructions.
• Adequate surgical space through septum excision is essential for successful LD/PD application.