Piezo-Assisted Dorsal Preservation in Rhinoplasty: When and Why.

[BACKGROUND] Preservation rhinoplasty philosophy with its "down techniques" is currently undergoing a renaissance. Its goal is to spare and preserve noble nasal structures such as ligaments, nerves and vessels, reducing to a minimum local tissue manipulation and avoiding the drawbacks and pitfalls associated with classic dorsal reconstruction techniques often resulting in irregularities which often lead to an increased rhinoplasty revision rate.

[METHODS] In this article, we reviewed 107 consecutive cases in which a variety of preservation techniques were used. Indications, surgical techniques and complications are also described.

[RESULTS] All reported procedures showed low complication rates with good cosmetic and functional outcomes.

[CONCLUSIONS] Tailoring the surgical technique is essential in rhinoplasty. Authors have developed and present an anatomy-based diagram to help surgeons in choosing the right approach for dorsal surgery.

[LEVEL OF EVIDENCE IV] This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .