New Approaches for the Let-Down Technique.

[BACKGROUND] In Western countries, dorsal hump reduction surgery is prevalent due to the nasal profiles of the patients admitted for esthetic rhinoplasty operations. There are numerous techniques for hump reduction. Currently, dorsal hump reduction techniques that allow the dorsum to be preserved are highly popular.

[OBJECTIVES] In the present research, the author describes several approaches for the let-down technique. These approaches are aimed at selecting the appropriate technique based on the patients' needs.

[METHODS] The patients with nasal hump deformities who had undergone operations were investigated. Fifty-one patients met the inclusion criteria and their records were assessed. All patients who were included in the study were assessed with the Rhinoplasty Outcome Evaluation (ROE) questionnaire at their one-year follow-up appointment. In the present study, six approaches were performed by the surgeon for the let-down technique.

[RESULTS] The ROE scores before and after 1 year of surgery were compared. The median of the ROE score before surgery was 65.2. The median score was 90.2 points 1 year after surgery. The ROE score significantly increased before and after surgery (p < 0.001). The patient satisfaction was found to be excellent in 92% of the included patients. There were no complications, and there was no need for revision surgery.

[CONCLUSION] These new approaches for the let-down technique will allow better short- and long-term cosmetic and functional outcomes and will enable surgeons to choose the best option for patients who are candidates for the let-down technique. Preoperative imaging of patients with nasal humps will also provide several advantages for both the surgeon and the patients.

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