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Facial Plast Surg
DOI: 10.1055/a-2575-3159
Original Article

Reduction Structured Rhinoplasty

Hailey M. Juszczak
1   Department of Otolaryngology-Head and Neck Surgery, SUNY Downstate Health Sciences University, Brooklyn, New York
,
George Ferzli 
2   Ferzli Facial Plastic Surgery, New York, New York
,
Thomas Romo III
3   Department of Otolaryngology-Head and Neck Surgery, Lenox Hill Hospital and Manhattan Eye, Ear and Throat Hospital (MEETH), Northwell Health Systems, New York, New York
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Abstract

Aims and Background

Reduction structured rhinoplasty is a rhinoplasty technique that combines elements from two rhinoplasty philosophies: simple reductive rhinoplasty and structural rhinoplasty. The goal is to achieve decreased nasal size while supporting a life-long, lasting nasal shape by employing the use of structural grafts.

Historical Aspects

Reducing nasal size without replacing disrupted nasal support structures has historically led to poor outcomes.

Techniques

Structural grafts include spreader grafts, onlay tip grafts, columellar strut grafts, caudal septal extension grafts, and more. They are utilized to prevent internal nasal valve collapse, provide tip support, and prevent tip ptosis, retraction, or poor healing outcomes due to scarring. Different materials, including autologous cartilage and allogenic implants (i.e., high-density porous polyethylene) can be used as graft material. Preference for specific graft use differs from surgeon to surgeon, and continuous debate exists surrounding which grafts provide the most optimal results.

Conclusion and Clinical Relevance

This study outlines Romo III's tenured approach to reduction structured rhinoplasty and discusses various trends and debates in grafts that are currently utilized.

Keywords

reduction structured rhinoplasty - structural rhinoplasty - nasal tip graft - onlay tip graft - columellar strut graft


Publication History

Article published online:
22 April 2025

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