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Facial Plast Surg
DOI: 10.1055/a-2689-1337
Original Research

Step-up Maneuver for Radix Control in Dorsal Preservation Rhinoplasty

José Carlos Neves 
1   Department of Facial Plastic Surgery, MyFace Clinic and Academy, Lisboa, Portugal
,
Jefferson Rijo-Cedeño
2   Department of Facial Plastic Surgery, MyFace Academy, Lisbon, Portugal
,
Halana Filgueiras
2   Department of Facial Plastic Surgery, MyFace Academy, Lisbon, Portugal
,
Diego Arancibia-Tagle
3   Department of Otolaryngology and Head and Neck Surgery, Hospital Universitari Son Espases, Palma de Mallorca, Baleares, Spain
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Abstract

Introduction

Radix control remains a key concern in preservation rhinoplasty. Consistent techniques for managing this area are essential for optimal outcomes.

Objectives and Hypotheses

This article presents the step-up maneuver, a novel technique for precise modulation of radix height while preserving structural integrity.

Study Design

Retrospective case series.

Methods

A retrospective analysis of 245 consecutive primary preservation rhinoplasties using the step-up maneuver between 2022 and 2023 was conducted.

Results

The subdorsal Tetris flap was employed in 86.1% of cases, whereas the low strip approach was used in 13.9%. Intraoperative outcomes included: Radix maintained—91.0%; Radix projected—2.9%; Radix deprojected—6.1%.

Conclusion

The step-up maneuver represents a significant advancement in preservation rhinoplasty, broadening its indications and reducing the risk of radix-related complications. These findings suggest that preservation rhinoplasty can be safely and effectively extended to a wider range of nasal anatomies, further refining surgical strategies and reducing revision rates.

Keywords

rhinoplasty - preservation - step-up

Declaration of GenAI Use

During the writing process of this article, the authors used Chat GPT4o to assist with English language editing. The tool did not contribute to the conceptual or substantive development of the work. The authors have reviewed and edited the text and take full responsibility for the content of the article.




Publikationsverlauf

Eingereicht: 18. April 2025

Angenommen: 31. Juli 2025

Accepted Manuscript online:
25. August 2025

Artikel online veröffentlicht:
19. September 2025

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