Dr. Cangello is among an elite few surgeons to offer preservation rhinoplasty, and is one of the first rhinoplasty surgeons to offer this technique in the U.S. This modern approach to nose reshaping preserves as much of the original nasal structure as possible. Retaining the existing tissue, cartilage, and bone allows for a natural-looking result, improved nasal function, and a lower risk of complications. Preservation techniques lend themselves well to nasal bridge concerns, such as removal of humps, general bridge reshaping, and correction of minor asymmetries.

Preservation Rhinoplasty Vs. Traditional Nasal Bridge Surgery

Preservation rhinoplasty offers several key benefits over traditional nasal bridge surgical techniques. While preservation rhinoplasty is not appropriate for every patient, Dr. Cangello employs this approach for up to 80% of patients seeking nasal bridge surgery. The first, and possibly most significant, difference is that the dorsum is completely preserved—which means that there is no need to reconstruct the dorsum and cartilage grafts are not needed. Rather than shave down the dorsum, any bone and cartilage removal occurs underneath the nose bridge and subsequently the intact dorsum can be easily repositioned to lower the height of the nasal bridge. This eliminates the possibility of dorsum irregularities and can cut down on revision rhinoplasty procedures.

Another key difference is that the dissection takes place in a different plane than most traditional nasal bridge surgeries. In a preservation procedure, the perichondrium and the periosteum are left intact. These thin tissue layers are adherent to the cartilage and bone (respectively) that compose the nasal structure. All of the lymphatics and blood vessels that supply the soft tissues of the nose are above these very thin (one cellular layer thick) layers. By dissecting the nose below the perichondrial and periosteal layers, the veins, arteries and lymphatics are all preserved, thereby almost eliminating bruising and swelling and minimizing the duration of the latter. This reduces the patient’s social downtime. Dr. Cangello is among the first and one of just a handful of rhinoplasty surgeons in the United States who perform this dissection technique.

Finally, the tip plasty approach in a preservation procedure emphasizes a more natural look that allows us to avoid some of the problems with nose tip proportion that can be tell-tale signs of rhinoplasty.