Push down/Let down Rhinoplasty.

Push down/Let down Rhinoplasty involves the most advanced surgical techniques in aesthetic nasal surgery. A nasal hump can be removed while preserving cartilage, bone and ligamentous structures of the nose. Due to this tissue preserving techniques patients experience less swelling after the surgery and the recovery time will be shorter.

Push down/Let down Rhinoplasty is part of Preservation Rhinoplasty. Basically the hump is removed by taking out a strip of the nose septum and pressing the nasal dorsum downwards.

To understand the technique better, imagine a Christmas tree that is too big. The tip of the Christmas tree is the nasal hump. In classic structure rhinoplasty the tip of the tree (nose hump) is removed and the tree looks ugly. In Push down/Let down Rhinoplasty a part of the tree trunk is removed and the tree set downwards. In this way the hump is gently pushed downwards to straighten the nose dorsum. No other manoeuvres are needed to reconstruct the nose dorsum. The original nose dorsum is preserved with cartilage, bone and ligamentous structures of the nose.

In contrast, classic structure rhinoplasty or nose job needs some kind of reconstruction of the nose dorsum. Classically two strips of cartilage are used to reconstruct the nose dorsum. The cartilage strips have two important functions. The first is to reconstruct the nasal dorsal lines from the eyebrows to the nose tip. The second and most important function is to keep the inner nasal valve open which is essential for breathing through the nose. If the nose dorsum is not reconstructed in classic structure rhinoplasty patients often experience the complication of an inverted V deformity. This involves a visible transition from bony pyramid to the cartilaginous dorsum. The nasal dorsal lines are absent. Breathing is often compromised and patients experience problems when doing sports and endurance activities.

Push down/Let down Rhinoplasty or nose job needs no manoeuvres as cartilage grafts to reconstruct the nose dorsum. The nose is straightened while preserving the original nose dorsum. As bone, cartilage and ligaments are preserved the nose is more stable and less prone to deformities in the healing process. Complications such as the above described inverted V deformity can be avoided. The dorsal nasal lines look more natural. Healing is in general faster compared to the classic structure rhinoplasty techniques.

In Push down/Let down Rhinoplastya superior or inferior strip of the septum can be removed to straighten the nose. Most breathing relevant deviations of the cartilaginous septum are encountered in the inferior part. By taking out the inferior strip the nose can be straightened and breathing improved simultaneously. The superior strip is used when there is no deviation of the nose septum and breathing function sufficient before the operation.

In summary, Push down/Let down Rhinoplasty has many advantages in contrast to classic structure rhinoplasty or nose job. Patients will experience less bruising and a faster postoperative recovery due preservation techniques. The nose dorsum is stable and does not require additional techniques to stabalize. Important to note is that not every nose dorsum/hump is approachable to preservation push down/let down techniques and in the end it's the decision of the surgeon to decide which technique will lead to the best results.

If you want to know Who Can Benefit from Nose Job Surgery?, please visit "Who is suitable for rhinoplasty procedure".