Push-Down Technique Without Osteotomy: A New Approach.

[BACKGROUND] Dorsal hump reduction is one of the most frequently performed rhinoplasty operations among white populations. The best method for preserving a natural nasal dorsum and avoiding revision surgery is to perform the push-down technique. The concept of the push-down technique is not new and has been improved over time.

[OBJECTIVES] In the present study, the author introduces a new approach for the push-down technique in which there is no need for osteotomy.

[METHODS] According to the inclusion and exclusion criteria, sixty-two patients were included in the present study. All patients who were included in the study were assessed with the Rhinoplasty Outcome Evaluation (ROE) questionnaire at their 1-year follow-up appointment. In the present technique, the superior dorsal cartilage was pushed down to the reverse side of the septal deviation, and the nasal dorsum was rasped with a micromotor rasping machine instead of undergoing osteotomy.

[RESULTS] The initial median ROE score was 68.5 points, and the postoperative median score was 90.5 points. A final score greater than 85 was considered excellent and an indication of high patient satisfaction. Among the sixty-two patients, 56 had a score greater than 85 points (90.32%) (p = 0.001). There were no complications, and there was no need for revision surgery.

[CONCLUSION] This push-down technique can be considered an easy and suitable approach for selected patient populations. Additionally, the recovery time is shortened with the push-down technique without osteotomy.

[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.