Why ‘Preservation Rhinoplasty’ May Be a Better Way To Do a Nose Job


While rhinoplasty remains one of the most popular, if not the most popular treatment facial transformation surgery—according to the American Society of Plastic Surgeons (ASPS), rhinoplasty was the most popular cosmetic surgical procedure performed in 2020—new techniques continue to emerge that make it easier for the patient to undergo.

When some patients finally get the opportunity to fulfill a longtime wish of getting a nose job, the first thing many of them ask their surgeon is: “Will you have to break my nose?” Depending on the need, oftentimes the answer is yes, which can instill a sense of dread and fear. Thankfully, the new “preservation rhinoplasty” technique is helping some patients emerge from their transformations with quite a bit more of their original anatomy intact.

What It Is

Leading the charge in what is called “preservation rhinoplasty,” Palo Alto, CA facial plastic surgeon Sam P. Most, MD says this technique can create an elegant, natural-looking result while maintaining the nose’s original structure. “I’ve been fortunate to be a leader in this specific type of rhinoplasty over the last four years. It’s a way we can perform the rhinoplasty and preserve the architecture of those without having to take the bridge apart and rebuild it,” says the surgeon.

Who It’s For

According to Dr. Most, the best candidates for “preservation rhinoplasty” are those with an attractive nose shape from the front and a dorsal hump that is not overly crooked. “The typical way this is addressed is that the surgeon will cut the top of the hump from inside the nose, break the bones and squeeze it all together to make it look normal again,” he explains. “So, if somebody has a nice-looking shape to their nose, rather than cut the top off, we do a “preservation rhinoplasty,” where we actually cut on the backside of the nose where it meets the face and push the whole thing into the face to make it flatter.”

Dr. Most says in his opinion the result appears more natural-looking because the top of the nose remains completely smooth. “There are no cut edges. And while we still have to break the bone, we’re cutting it at a deeper point, where the skin is very thick along the face, and you don’t feel it.”