The Various Shades of Hybridism in Rhinoplasty: Variations on Dorsal Preservation and Presentation of a Cartilaginous Pushdown Technique.

[INTRODUCTION] The growing interest in preservation techniques gave rise to many variations classified under the term hybrid rhinoplasty.

[OBJECTIVES AND HYPOTHESES] The objective of this study is to specify the various meanings of hybridism in rhinoplasty tracing the term back in time and to present our contemporary practice in the management of the middle vault.

[STUDY DESIGN] Review of the medical literature about hybrid rhinoplasty and retrospective cohort study of patients submitted to hump reduction with cartilaginous preservation and pushdown.

[METHODS] A total of 75 patients submitted to primary rhinoplasty consisting in hump reduction with complete removal of the osseous hump and cartilaginous pushdown and evaluated for functionality and aesthetic satisfaction.

[RESULTS] Cartilaginous pushdown results in great functional and aesthetic success with low rates of complications or recurrences.

[CONCLUSIONS] Studying the literature, we recognized three distinct entities of hybridism in rhinoplasty. One of these is the variations on dorsal preservation techniques. Cartilaginous pushdown is a true hybrid technique standing between structural hump removal and complete dorsal preservation.