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Facial Plast Surg 2021; 37(01): 036-044
DOI: 10.1055/s-0040-1714672
Original Article

The Segmental Preservation Rhinoplasty: The Split Tetris Concept

José Carlos Neves
1   Department of Facial Plastic Surgery, My Face, Clinics and Academy, Lisbon, Portugal
,
Diego Arancibia-Tagle
2   Department of Otolaryngology—Head and Neck Surgery, Hospital Universitari Son Espases, Baleares, Spain
,
Wilson Dewes
3   Department of Facial Plastic Surgery, Clinica Dewes, Lajeado, Brazil
,
Mario Ferraz
4   Department of Facial Plastic Surgery, Clinica Mario Ferraz, Campinas, Brazil
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Abstract

Dorsal preservation rhinoplasty has seen considerable advances in the recent years as many doctors have improved and developed new ideas on the subject. In the era of minimal trauma surgery, it is important to achieve a beautiful nasal aesthetic result with minimum injury to the nose. Preserving the main structures of the nasal pyramid has been pursued for more than a century, and some different approaches have been described and developed since then. Their strengths and weakness have been shown. The present society's demand for perfection is an added reason for improving the stability and predictability of preservation rhinoplasty. We describe a brand-new philosophy of approaching the nasal dorsum hump that combines both safety and delicacy in dealing with the anatomical structures with elegancy and accuracy and achieving the aesthetic goal required.

Keywords

preservation rhinoplasty - letdown - pushdown - split Tetris concept - Vitruvian Man split maneuver


Publication History

Article published online:
04 September 2020

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  • References

  • 1 Neves JC, Arancibia Tagle D, Dewes W. et al. The split preservation rhinoplasty: “the Vitruvian Man split maneuver. Eur J Plast Surg 2020; 43: 323-333
    CrossrefPubMedGoogle Scholar
  • 2 Cottle MH, Loring RM. Corrective surgery of the external nasal pyramid and the nasal septum for restoration of normal physiology. Ill Med J 1946; 90: 119-135
    Google Scholar
  • 3 Cottle MH. Nasal roof repair and hump removal. AMA Arch Otolaryngol 1954; 60 (04) 408-414
    CrossrefPubMedGoogle Scholar
  • 4 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 Cabeca Pescoco 2013; 42 (03) 13
    PubMedGoogle Scholar
  • 5 Atolini Junior N, Lunelli V, Lang GP, Melotti LF, Yamamoto TT, Munerolli EJ. Septum pyramidal adjustment and repositioning – a conservative and effective rhinoplasty technique. Braz J Otorhinolaryngol 2019; 85: 176-182
    CrossrefPubMedGoogle Scholar
  • 6 Ulloa FL. . Let down technique. Accessed January 11, 2017 at: http://www.rhinoplastyarchive.com/articles/let-down-technique
  • 7 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
    CrossrefPubMedGoogle Scholar
  • 8 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
    Google Scholar
  • 9 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
    CrossrefPubMedGoogle Scholar
  • 10 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
    CrossrefPubMedGoogle Scholar
  • 11 Sebileau P, Dufourmentel L. Correction Chirurgicale des Difformités Congénitales et Acquises de la Pyramide Nasale. Paris: Arnette; 1926: 104-105
    Google Scholar
  • 12 Maurel G. Chirurgie Maxilla-Faciale. Paris: Le François; 1940: 1127-1133
  • 13 Huizing EH. Push-down of the external nasal pyramid by resection of wedges. Rhinology 1975; 13 (04) 185-190
    PubMedGoogle Scholar
  • 14 Gola R. Conservative rhinoplasty [in French]. Ann Chir Plast Esthet 1994; 38 (03) 239-252
    PubMedGoogle Scholar
  • 15 Gola R. La Rhinoplastie Fonctionnelle et Esthétique. Paris: Springer-Verlag; 2000: 360
    Google Scholar
  • 16 Gola R. Functional and esthetic rhinoplasty. Aesthetic Plast Surg 2003; 27 (05) 390-396
    CrossrefPubMedGoogle Scholar
  • 17 Joseph J. The classic reprint: nasal reductions. Plast Reconstr Surg 1971; 47 (01) 79-83
    CrossrefPubMedGoogle Scholar
  • 18 Joseph J. Beitrage zur rhinoplastik. Berl Klin Wochenschrift 1907; 16: 470-472
    PubMedGoogle Scholar