Combination of the Push-Down and Let-Down Techniques: Mix-Down Approaches
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ORIGINAL ARTICLE
RHINOPLASTY
Combination of the Push-Down and Let-Down Techniques: MixDown Approaches ¨ ztu¨rk1 Gu¨ncel O
Received: 11 August 2020 / Accepted: 4 October 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Abstract Background Rhinoplasty is one of the most widely conducted and challenging types of aesthetic surgical operations, and dorsal hump reduction is a commonly performed aesthetic surgery among Caucasian patients. Dorsal hump resection is traditionally conducted by removing the dorsal nasal bone and cartilage. The push-down and let-down techniques are used for dorsal preservation in dorsal hump reduction operations. Different patients require different approaches to achieve the best results in terms of aesthetic appearance and functionality. Objectives In the present research, the author describes two novel approaches that combine the push-down and letdown techniques for appropriate patients. Methods The records of 45 patients (40 females and 5 males) were assessed, and those who were eligible for the present approaches were included. The author defined two approaches in which the push-down and let-down techniques were used simultaneously (mix-down methods). All patients included in the study completed the Rhinoplasty Outcome Evaluation (ROE) questionnaire before surgery and at their one-year follow-up appointment. Results The median ROE scores were 60.1 points before surgery and 92.2 points one year after surgery; this difference was statistically significant (p\0.001). Conclusions The present study is the first to demonstrate the beneficial effects of combining the push-down and letElectronic supplementary material The online version of this article (https://doi.org/10.1007/s00266-020-02012-6) contains supplementary material, which is available to authorized users. ¨ ztu¨rk & Gu¨ncel O [email protected] 1
Nisantasi University, ˙Istanbul, Turkey
down techniques in a selected patient population. These new approaches will improve both cosmetic and functional outcomes and allow surgeons to choose the best option for patients who are eligible for these mix-down approaches. 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 the Table of Contents or the online Instructions to Authors www.springer.com/00266. Keywords Push down Let down Dorsal Preservation
Introduction Rhinoplasty is one of most widely performed and challenging types of aesthetic surgical operations [1, 2]. The main purpose of aesthetic rhinoplasty operations is to create an ideal nasal profile for patients. However, patients’ needs can vary in terms of nasal aesthetics, and plastic surgeons must find a way to describe the most suitable method or approach to patients [3, 4]. Dorsal hump reduction is a commonly conducted aesthetic surgery among Caucasian patients. Dorsal hump resection is traditionally performed by r
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