Should I Choose Preservation Rhinoplasty? 
Preservation rhinoplasty is a nasal surgery technique dating back to the 1800s. It’s not a new procedure and was initially known as “push down” or “let down” rhinoplasty. Instead of removing and reshaping the nasal hump, this technique pushes the hump down into the nose structure. In my opinion, the only thing “preserved” with this approach is the risk of the hump reappearing and the nasal tip remaining overly projected. These risks are significant and not worth taking. Not all rhinoplasty cases involve large humps, and those that don’t aren’t suitable for this procedure. The term “preservation” was mainly used as a marketing tool, as there’s little actual preservation beyond these risks. Surgeons are often looking for a marketing advantage, so it’s essential for patients to do thorough research and have detailed consultations to find the best approach for their needs. I don’t recommend open rhinoplasty or preservation rhinoplasty because neither offers meaningful preservation. It’s important for rhinoplasty patients to understand the different philosophies and artistic approaches involved in the surgery. The procedure is highly personal, meaning the surgeon and patient must agree on what will look best for the patient’s face. Also, there’s a style difference between ENT surgeons and plastic surgeons. In my opinion, plastic surgeons tend to create more refined, elegant results. At our practice, we specialize in rhinoplasty, performing many surgeries each year using the closed technique, which improves the nose’s structure without pushing the hump down. In summary, preservation rhinoplasty doesn’t truly preserve anything and comes with unnecessary risks that can lead to disappointing results. 
Preservation rhinoplasty is a nasal surgery technique dating back to the 1800s. It’s not a new procedure and was initially known as “push down” or “let down” rhinoplasty. Instead of removing and reshaping the nasal hump, this technique pushes the hump down into the nose structure. In my opinion, the only thing “preserved” with this approach is the risk of the hump reappearing and the nasal tip remaining overly projected. These risks are significant and not worth taking. Not all rhinoplasty cases involve large humps, and those that don’t aren’t suitable for this procedure. The term “preservation” was mainly used as a marketing tool, as there’s little actual preservation beyond these risks. Surgeons are often looking for a marketing advantage, so it’s essential for patients to do thorough research and have detailed consultations to find the best approach for their needs. I don’t recommend open rhinoplasty or preservation rhinoplasty because neither offers meaningful preservation. It’s important for rhinoplasty patients to understand the different philosophies and artistic approaches involved in the surgery. The procedure is highly personal, meaning the surgeon and patient must agree on what will look best for the patient’s face. Also, there’s a style difference between ENT surgeons and plastic surgeons. In my opinion, plastic surgeons tend to create more refined, elegant results. At our practice, we specialize in rhinoplasty, performing many surgeries each year using the closed technique, which improves the nose’s structure without pushing the hump down. In summary, preservation rhinoplasty doesn’t truly preserve anything and comes with unnecessary risks that can lead to disappointing results.THOMAS TREVISANI, MD
BOARD-CERTIFIED PLASTIC SURGEON
MEMBER OF THE AMERICAN SOCIETY OF AESTHETIC PLASTIC SURGERY