We found that patients with lower literacy degree were more satisfied with the procedure. Rhinoplasty surgery significantly improved patient quality of life regarding nose function and appearance.

Background Hump resection often requires reorganization of the keystone area. Objectives The authors sought to describe the importance of the point where the perpendicular plate of ethmoid joins the septal cartilage (SC) and the nasal bones (NB) (Ethmoidal point [E-point]) for hump resection surgical planning. Methods Measurements from mid-sagittal slices in nasal computed tomography scans taken in adult Caucasian patients between January 2015 and December 2018 were compared between patients seeking primary rhinoplasty due to a nasal hump and patients not seeking rhinoplasty (control group). Patients with previous nasal surgery or trauma, genetic or congenital facial disorders, and high septal deviation were excluded. The length of overlap between NB and SC was compared between the 2 groups. The location of the E-point in relation to the beginning of the nasal hump in the cephalocaudal direction was documented in the patients seeking rhinoplasty. Results The study population included 138 patients, 69 seeking and 69 not seeking rhinoplasty (96 females). The mean age was 32.9 years (range, 18-55 years). The length of overlap between NB and SC was similar between both groups (11.7 ± 3.3 vs 10.8 ± 3.3; P = 0.235). The E-point was located before the beginning of the nasal hump in 97% (67/69) of nasal hump patients, and it could be found a mean distance of 2.3 (±2.3) mm cephalic to the latter. Conclusions As a rule, the perpendicular plate of the ethmoid does not contribute to the nasal hump; therefore, only in exceptional cases should this be addressed while performing dorsal reduction. Level of Evidence: 3

Background The majority of Caucasian aesthetic rhinoplasty patients complains about a noticeable hump in the profile view. Based on the integrity of the middle vault, there are two ways to dehump a nose: the structured technique and the preservation technique. Objectives We compared the aesthetical and functional outcomes of two techniques utilized for reduction rhinoplasty. Methods We performed a prospective, randomized, interventional, and longitudinal study on 250 patients randomly divided into two groups: the component dorsal hump reduction group (CDRg) (n = 125) and the spare roof technique group (SRTg) (n = 125). We utilized the Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty. Patients answered the questionnaire before the surgery, and at 3 and 12 months after surgery. In addition, we utilized a Visual Analog Scale (VAS) to score nasal patency for each side. Results Analyses of the preoperative and postoperative aesthetical VAS scores showed a significant improvement in both groups, from 3.66 to 7.00 (at 3 months) and to 7.35 (at 12 months) in CDRg, and from 3.81 to 8.14 (at 3 months) and to 8.45 (at 12 months) in SRTg. Analyses of postoperative means of aesthetic VAS scores showed a significant improvement in both groups over time. However, aesthetical improvement was higher in SRTg than CDRg, concerning 3 (P < .001) and 12 months (P < 0.001) postsurgery. Analyses of the mean functional VAS scores showed a significant improvement in both techniques, with a better result for SRTg. Conclusions The spare roof technique (SRT) is a reliable technique that can help deliver consistently better aesthetical and functional results in reduction rhinoplasty over component dorsal hump reduction CDR in Caucasian patients with dorsal hump.

The Portuguese version of "The Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty" is a valid instrument to assess patients' outcomes following rhinoplasty surgery.

To our knowledge, the spare roof technique (SRT) is the first technique that is based on a complete skeletonization/preservation of the upper lateral cartilages. This technique is used to keep the natural roof of the nose's middle third, while dehumping and/or correcting the crooked septum. From January 2014 till March 2015, a total of 40 rhinoplasties were performed through the SRT: 28 reduction rhinoplasties, 6 complex crooked noses (with extracorporeal septoplasty), and 6 mixed cases. The SRT is an excellent middle third technique. The natural roof was kept and fitted the accurate new position in almost all cases with no surgical complexity. It is an easy technique with many applications and it is also very useful in the classical humpectomy of the Caucasian nose and correction of the crooked nose.

Preservation rhinoplasty in general and dorsal preservation in particular are for sure one of the most attractive topics in modern rhinoplasty and probably the most puzzling concept in this field. Recent major meetings and many other publications have led to an increased interest in these old/new techniques. New strategies for preservation have been developed in recent years, with a broader range of indications than the older push/let down. A simple classification urges to clarify this puzzled semantic concept of ''preservation''. Is it possible to systematize all new preservation variations in a simple classification? Yes, in this viewpoint, we propose a simple classification that systematizes all kinds of preservation techniques-the old and the new techniques. Classifying preservation will clarify the relative position of all techniques. It will allow comparing procedures from similar families there so to compare outcomes and indications from each technique.

Objective Assess the aesthetic and functional outcomes of the first 100 patients who underwent reduction rhinoplasty with the spare roof technique (SRT). Methods Prospective, interventional, and longitudinal study performed on consecutive patients undergoing primary rhinoplasty by SRT. All the surgical procedures were performed by the surgeon who first described this technique. The validated Portuguese version of the Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty was used. Patients completed the questionnaire presurgery and again 3 and 12 months postsurgery. In addition, a visual analogue scale (VAS) was used to score nasal patency for both sides. Results The study population included 100 Caucasian Mediterranean patients (33 males; 67 females). Mean age at surgery was 32.8 years. Analysis of the preoperative and postoperative mean aesthetic VAS scores showed a significant improvement from 3.67 to 8.1 (P < 0.001) and 8.44 (P < 0.001), respectively, 3 and 12 months postsurgery. Analysis of the five aesthetic Likert scale questions all showed a highly significant improvement after rhinoplasty. The mean preoperative aesthetic sum score was 13.9, which improved to 8.26 and 7.08, respectively, 3 and 12 months postsurgery (P < 0.001), indicating a significant improvement of subjective body image in relation to nasal appearance. Analysis of the preoperative and postoperative mean functional VAS score showed a significant improvement on both sides. Conclusion This prospective statistical study confirms that SRT significantly improved patient quality of life regarding nose function and appearance. It is a reliable technique that can help deliver consistently good results in reduction rhinoplasty in Caucasian patients with dorsal hump seeking rhinoplasty. Level of Evidence 2 Laryngoscope, 129:2702–2706, 2019

ObjectiveTo describe the average values of the nasal anthropometric measurements of Caucasian Mediterranean patients seeking rhinoplasty and evaluate the major nasal deformities.DesignProspective, observational and cross‐sectional study.SettingCentro Hospitalar do Porto.ParticipantsA 100 Caucasian Mediterranean patients seeking rhinoplasty.OutcomesStandardized photography was used to obtain nasal anthropometric measurements and to evaluate the major nasal defects. Data regarding age, gender, skin type and Fitzpatrick scale were also collected.ResultsThere was a statistically significant difference in the means values of palpebral fissure, intercanthal width, upper lip height, nasal root width, morphological nose width, nose height, nasal tip projection and nasofrontal–hump and nasofrontal–supratip angles between females and males. The major nasal deformity was dorsal hump (78.0%), followed by rinomegalia (53.0%) and boxy bulbous tip (47.0%).ConclusionThe present study shows statistically significant gender differences between anthropometric nasal measurements and the mean values are greater than standard values obtained on general population. This might be one of the reasons why Caucasian Mediterranean patients seek aesthetical rhinoplasty. On both genders, dorsal hump, rinomegalia and boxy bulbous tip were the major nasal defects. This emphasize the importance of rhinoplasty techniques designed to reconstruct nasal dorsum and nasal tip on Caucasian Mediterranean patients. To the best of our knowledge, our study is the first study of digital anthropometric nasal analysis and evaluation of major nasal defects specifically in Caucasian Mediterranean patients who applied for rhinoplasty. With this results, we provide a reference material for the evaluation of the Caucasian and Mediterranean patient when planning a cosmetic nasal surgery.