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Preservation Society: Facial Plastic Surgeons Talk Rhinoplasty

by | Apr 3, 2020 | Blog

Dr George Marcells maintains his status as one of Australia’s pre-eminent facial plastic surgeons by keeping abreast of bio-anatomical concepts, new instrumentation, and new techniques in rhinoplasty. Last month, he met with like-minded colleagues in Nice for The Preservation Rhinoplasty Congress. The gathering brought together hundreds of participants from dozens of countries to explore ways to correct noses with greater predictability and less risk. Their focus: preservation rhinoplasty.

“This philosophical approach to rhinoplasty allows the surgeon to attempt to preserve as much natural structure as possible,” says Dr Jay Calvert, President of the U.S. Rhinoplasty Society (This March, the American Society will partner with the European Society to hold international meetings in Germany to further explore this topic and others.)

Preservation Rhinoplasty: How A Good Things Gets Better

Rhinoplasty for cosmetic purposes gained popularity in the 19th Century when the life-changing nasal surgery gave a young man the confidence he needed to leave his home. (He was becoming a hermit.) At that time and still today, significant amounts of normal cartilage and bone were removed during rhinoplasty in order to decrease the size of the nose. Unless performed with expertise, the risk is that the nose will have an unnaturally pinched and scooped out appearance.

“The goal of preservation rhinoplasty is to preserve the bone and cartilage as they are important structural components in creating an aesthetically pleasing result,” says Dr Marcells. Here’s how it’s done…

Beneath the Skin: What Happens in Preservation Rhinoplasty?

The preservation rhinoplasty approach is used to preserve the natural dorsum of a patients nose. “In traditional rhinoplasty, the dorsum is shaved, cut down or rasped to improve its contours,” explains Dr Marcells. “When the process is complete, grafts need to be placed so that the dorsum can be reconstructed.” The primary problem with this approach is the risk of unsightly abnormalities due to a surgeon’s poor reconstructive technique. “This is especially problematic for thin-skinned patients,” Dr Marcells observes. 

This is not a risk in preservation rhinoplasty. The surgeon removes tissue from below the natural dorsum, leaving the entire structure undamaged. “After removing the tissue, the surgeon moves the natural dorsum in place which minimises the need for numerous grafts.”

Preservation Rhinoplasty vs Traditional Rhinoplasty

Is a structure-saving preservation rhinoplasty better than a tradition one? The answer is as complex as nasal surgery itself. “Not everyone will be benefitted by this approach,” says Dr Marcells. In particular, it is not recommended for individuals who have had a previous rhinoplasty. In order to determine which surgical approach is best, a qualified facial plastic surgeon needs to know your medical history, your surgical goals, and especially your facial physiology.

That being said, preservation rhinoplasty does deliver benefits that other techniques do not:

  • Preserves the Nasal Bridge – treatment of nasal hump without disruption of the native framework of the nose and the risk of abnormal healing.

  • Preserves Soft Nasal Tissue – preserving the nose’s soft tissue envelope and ligaments reduces the risk of post-operative complications.
  • Preserves Alar Cartilages – preserves cartilage segments in the nasal tip to reduce the need for revision surgery at a later date.

Be in the Know About Nose Surgery

Are you and your nose in an abusive relationship? Do you say mean things to it when you see it in the mirror? Do you bend it every which way trying to imagine how it would look with different contours? Let us help. At our practice in Bondi Junction, we know noses inside and out. We invite you to contact us today to arrange for a consultation.

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Meet Dr Marcells

MBBS (Syd), FRACS (ORL-HNS)
Past President – Australasian Academy of Facial Plastic Surgeons

Dr George Marcells is known for excellence in facial plastic surgery and is considered a true master of rhinoplasty. He performs advanced surgical techniques to restore balance and harmony to the face and can also resolve functional issues such as breathing difficulties.

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