Facial Plast Surg 2021; 37(01): 022-028
DOI: 10.1055/s-0041-1725102
Original Article

Conservative Surgery of the Nasal Dorsum: Septal Pyramidal Adjustment and Repositioning

Wilson Dewes
1   Department of Facial Plastic Surgery, FUNDEF and Clinica Wilson Dewes, Lajeado, Rio Grande do Sul, Brazil
,
2   Department of Facial Plastic Surgery, Clinica Pró-Vida, Tubarão, Santa Catarina, Brazil
,
Mario B.J. Ferraz
3   Department of Facial Plastic Surgery, IBCFPRS, Clinica Mario Ferraz, Campinas, Sao Paulo, Brazil
,
José Carlos Neves
4   Department of Facial Plastic Surgery, IBCFPRS/EBCFPRS, MYFACE Clinic, Lisboa, Portugal
› Institutsangaben

Abstract

The term SPAR (septum pyramidal adjustment and repositioning), aims to conserve the nasal dorsum without detachment of the upper lateral nasal cartilage of the nasal septum, based on the Cotte's principles, unlike classical rhinoplasty. The aim of the study is to describe surgical technique of SPAR with the surgical steps used to reviewing the literature on the surgical treatment of the nasal dorsum. This is a less invasive form of rhinoplasty, but no less effective, not being necessary additional techniques to nasal reconstruction, and preservation of essential nasal structures. It is an evolution of push down and the other conservative surgery, making a more modern technique and may be suitable for most types of cavities. More studies are needed, especially comparative, showing the following late sequelae, complications, and their long-term results.



Publikationsverlauf

Artikel online veröffentlicht:
11. März 2021

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  • References

  • 1 Ferraz MBJ, Zappelini CEM, Carvalho GM, Guimarães AC, Chone CT, Dewes W. Cirurgia conservadora do dorso nasal—a filosofia do reposicionamento e ajuste do septo piramidal (SPAR). Rev Bras Cir Cabec¸a Pescoc¸o. 2013; 42: 124-130
  • 2 Atolini Junior N, Lunelli V, Lang GP, Melotti LF, Yamamoto TT, Muneroli EJ. Septum pyramidal adjustment and repositioning—a conservative and effective rhinoplasty technique. Rev Bras Otorrinolaringol (Engl Ed) 2019; 85: 176-182
  • 3 Lothrop OA. An operation for correcting the aquiline nasal deformity. The use of new instrument. Report of a case. Boston Med Surg J 1914; 170: 835-837
  • 4 Hol MKS, Huizing EH. Treatment of inferior turbinate pathology: a review and critical evaluation of the different techniques. Rhinology 2000; 38 (04) 157-166
  • 5 André RF, Vuyk HD. Reconstruction of dorsal and/or caudal nasal septum deformities with septal battens or by septal replacement: an overview and comparison of techniques. Laryngoscope 2006; 116 (09) 1668-1673
  • 6 Eisenberg I. A history of rhinoplasty. S Afr Med J 1982; 62 (09) 286-292
  • 7 Huizing EH. Push-down of the external nasal pyramid by resection of wedges. Rhinology 1975; 13 (04) 185-190
  • 8 Gola R, Nerini A, Laurent-Fyon C, Waller PY. Conservative rhinoplasty of the nasal canopy. Ann Chir Plast Esthet 1989; 34 (06) 465-475
  • 9 Gola R. Functional and esthetic rhinoplasty. Aesthetic Plast Surg 2003; 27 (05) 390-396
  • 10 Saban Y, Braccini F, Polselli R. Rhinoplasty: morphodynamic anatomy of rhinoplasty. Interest of conservative rhinoplasty. Rev Laryngol Otol Rhinol (Bord) 2006; 127 (1-2): 15-22
  • 11 Saban Y, Daniel RK, Polselli R, Trapasso M, Palhazi P. Dorsal preservation: the push down technique reassessed. Aesthet Surg J 2018; 38 (02) 117-131
  • 12 Harel M, Margulis A. Dorsal augmentation with diced cartilage enclosed with temporal fascia in secondary endonasal rhinoplasty. Aesthet Surg J 2013; 33 (06) 809-816
  • 13 Shipchandler TZ, Chung BJ, Alam DS. Saddle nose deformity reconstruction with a split calvarial bone L-shaped strut. Arch Facial Plast Surg 2008; 10 (05) 305-311
  • 14 Almeida GS, Pessoa BBGP, Oliveira NGS. Reconstrução do Terço Médio Nasal em Rinoplastia Primária. Rev Bras Cir Plást 2008; 23 (02) 124-127
  • 15 Montes-Bracchini JJ. Nasal profile hump reduction using the Let-Down technique. Facial Plast Surg 2019; 35 (05) 486-491
  • 16 Kosins AM, Daniel RK. Decision making in preservation rhinoplasty: 100 case series with one-year follow-up. Aesthet Surg J 2020; 40 (01) 34-48
  • 17 Cottle MH. John Orlando Roe, pioneer in modern rhinoplasty. Arch Otolaryngol 1964; 80: 22-27
  • 18 Patel PN, Abdelwahab M, Most SP. A review and modification of dorsal preservation rhinoplasty techniques. Facial Plast Surg Aesthet Med 2020; 22 (02) 71-79
  • 19 Ishida J, Ishida LC, Ishida LH, Vieira JC, Ferreira MC. Treatment of the nasal hump with preservation of the cartilaginous framework. Plast Reconstr Surg 1999; 103 (06) 1729-1733 , discussion 1734–1735
  • 20 Tuncel U, Aydogdu O. The probable reasons for dorsal hump problems following let-down/push-down rhinoplasty and solution proposals. Plast Reconstr Surg 2019; 144 (03) 378e-385e