Refining Patient Selection in Hybrid Dorsal Preservation Rhinoplasty: A Review of 50 Patients

Summary: Dorsal preservation rhinoplasty (DPR) refers to the preservation of the nasal mid-vault during rhinoplasty. It can be performed in conjunction with open structural tip rhinoplasty as a hybrid approach to rhinoplasty. Implementing DPR requires careful patient selection to optimize outcomes, as DPR in unfavorable cases can result in destabilizing effects on the nasal framework and function. After reviewing outcomes of 50 consecutive patients undergoing hybrid rhinoplasty using DPR, the authors devised an algorithm for careful patient selection. This algorithm is a pragmatic approach for when and how to perform DPR that incorporates both the bony and cartilaginous components. Using this guiding algorithm will simplify DPR and result in improved outcomes in selected patients. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.