Dorsal Modification: Practical Applications in Rhinoplasty.

[BACKGROUND] Management of the dorsum continues to present challenges for rhinoplasty surgeons, especially regarding the inherent asymmetry of the bony and cartilaginous vaults and the need for a highly individualized approach for each case.

[OBJECTIVES] The aim of this study was to assess the efficiency of superficial dorsal modification to improve the shape and symmetry of the dorsum, without resecting/reconstructing the main parts that maintain dorsal stability.

[METHODS] A total of 147 patients who underwent superficial dorsal modification between October 2020 and March 2024 were retrospectively reviewed. A step-by-step algorithm was applied to achieve the required dorsal improvement.

[RESULTS] The average postoperative follow-up period was 27 months (range, 12-41 months). No patients required revision surgery of their dorsum. No complications were reported. A retrospective analysis of the 147 patients demonstrated aesthetic and functional improvement.

[CONCLUSIONS] Dorsal modification as a separate philosophy is a very conservative, fast, and reliable approach. In cases where there is no need to significantly change dorsal dimensions (height and width), dorsal modification improves the dorsum quickly and efficiently without significant resection and no reconstruction, while maintaining stability and maximum predictability.