The nose should be considered as a functional unit, one of the elements of this concept is form. Form and function should not be separated from each other. Elements of nasal structure should be seen as a part of a whole and thus treated as one. Any change to one of the structures will have an impact on the other ones, both functionally and aesthetically. If we perfectly understand the dynamic relationship of the components, more pleasant and natural results without surgical scars can be achieved. By adhering to the philosophy of tissue preservation and repositioning, a balance can be established between the correction of the nasal skeleton and the rest of the soft tissues that make up the nose. In this way, the function of the nose can be fully preserved without sacrificing what is perceived as a functional nose for the sake of shape.

What are the advantages of Let Down & Push Down Preservation Rhinoplasty?

The key to a successful rhinoplasty lies in the septum; aligning it, relieving coronal and axial tension, allows it to provide central stability to the nose. The Let Down and Push Down techniques correct the problems in the septum by preserving  the natural connection between the dorsum and bone structure, cartilage tissue and lobule.

In Let Down and Push Down Preservation Rhinoplasty, the face and nose are fully evaluated, because the basis of success in rhinoplasty is diagnosis. Evaluation includes pre-operative photographs, nasal video endoscope, and a complete clinical examination.

How to prepare for Let Down & Push Down rhinoplasty?

Paying particular attention to the pyramid of the nose, both bony and cartilaginous, determine if it is centered on the midline, if it is high and tense, or if there is any right or left deviation is key.
Considering that the presence of septal cartilage pathology creates asymmetry and deviation in the cartilage pyramid, the relationship of the upper lateral cartilages (ULC) and lower lateral cartilages (LLC) with the septal cartilage  evaluated. Once the pathology has been identified and an integrated diagnosis is reached, individualized planning is made to correct it.

The key to a successful septo-rhinoplasty lies in the septum; aligning it, relieving coronal and axial tension, allowing a central stability to the nose.

How Let Down & Push Down Preservation Rhinoplasty is performed?

Nose surgery performed with the closed technique takes an average of 2 hours. Surgery is performed under general anesthesia. Nasal bone and cartilage tissues are corrected by preserving the connective tissues in the nose. Since the incisions are made from inside the nostrils, no visible scars occur. A splint is placed on the nose, and before that, a protective tape is placed under it. Patient usually stays 1 night at the hospital.

What is the difference between Let Down and Push Down Rhinoplasty?

The difference lies in the height of the hump in the nasal structure. If the height of the hump is greater than 3 mm’s Let Down technique is applied, if it is lower than 3 mm’s Push Down is applied.

Aftercare

In Let Down & Push Down Preservation  Rhinoplasty, the recovery time of the patients is shorter. Patients can return to their routine within seven days. The probability of bruising in patients is very low. Swelling increases in the first 48 hours after the surgery and then dissolves rapidly. After the operation, patients experience a more pain-free and more comfortable period. Pain that occurs in the form of mild tingling can be controlled with painkillers. Patients are generally advised to rest for a week after the surgery. After the first week, light-paced sports can be started gradually.

When the Let Down & Push Down technique is learned and applied correctly, the results are very satisfying in terms of aesthetics and the function of the nose and can be maintained and continued.