Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Aug 12.
doi: 10.1007/s00266-025-05139-6. Online ahead of print.

Roof Modification Methods in Preservation Rhinoplasty

Umut Tuncel  1 , Onur Hasret Yurtsever  2 , Goran Lazovic  3 , Muhsin Kiran  2 , Nilsou Chalats  4
Affiliations
Review

Roof Modification Methods in Preservation Rhinoplasty

Umut Tuncel et al. Aesthetic Plast Surg. .

Abstract

Background: The techniques for roof modification in the context of preservation rhinoplasty focus on altering the nasal roof, which is composed of both bone and cartilage elements, without the necessity of excision while preserving its structural integrity. These techniques are particularly indicated in cases where dorsal humps require modification, as they address potential complications of rhinoplasty, such as hump recurrence, asymmetry, or nasal dorsal irregularities.

Material methods: This review analyzed roof methods in the preservation rhinoplasty context. The following keywords were used to identify articles related to roof methods describing a novel technique or modification: rhinoplasty, preservation rhinoplasty, full preservation methods, dorsal preservation, surface operations, hybrid methods, roof flap, or graft in rhinoplasty. Furthermore, the paper aims to highlight the differences among the roof techniques and to disclose indications of the roof methods.

Results: We achieved and presented three roof articles and techniques. Based on the articles' analysis, current popular techniques emphasize preserving the integrity of the nasal dorsum or nasal pyramid, which repositions the dorsum instead of excising it. Roof methods mainly involve creating dorsal roof flaps with various geometric designs and differing degrees of soft tissue preservation. This approach significantly improves natural aesthetic outcomes by reducing the dissection of skin and soft tissue while preserving the integrity of the roof.

Conclusion: It is our thought that roof techniques will gain greater significance over time in achieving a harmonious nasal profile, preserving functional integrity, and reducing postoperative complications. Developments in preservation rhinoplasty will further enhance the roof techniques, enabling their more frequent application even in difficult cases, and this will solidify their role as a fundamental part of modern rhinoplasty practices, resulting in improved aesthetic outcomes and faster recovery times.

Level of evidence ii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Keywords: Dorsal preservation; Hybrid methods; Modification; Nasal dorsum; Roof.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflict of Interest: The authors declared no potential conflicts of interest regarding the research, authorship, and publication of this article. Ethical Approval: This study is a systematic review that includes a secondary analysis of data published by other authors. Informed Consent: For this type of study, informed consent is not required. Human and Animal Rights: This article does not include any studies involving human participants or animals conducted by any of the authors.

References

    1. Daniel RK. Rhinoplasty: the retractable roof. Plast Reconstr Surg. 1989; 83(6): 976-83; discussion 984.
    1. Tuncel U, Aydogdu IO, Kurt A. Reducing dorsal hump recurrence following push down-let down rhinoplasty. Aesthet Surg J. 2021;41(4):428–37. - PubMed
    1. Tuncel U, Aydogdu O. The probable reasons for dorsal hump problems following let-down/push-down rhinoplasty and solution proposals. Plast Reconstr Surg. 2019;144(3):378e–85e. - PubMed
    1. Toriumi DM, Kridel RWH, Papel ID, Most SP, Patel PN. Dorsal preservation versus structural techniques and their application. Facial Plast Surg Clin North Am. 2024;32(4):603–24. - PubMed
    1. Öztürk G. Hybrid preservation rhinoplasty: combining mix-down and semi let-push down techniques. J Craniofac Surg. 2022;33(6):1885–9. - PubMed

LinkOut - more resources