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Mediterranean Noses: The Tension Nose Deformity and Preservation Rhinoplasty

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Mediterranean Rhinoplasty


Tension nose deformity (TND) is the most frequent type of Mediterranean nose. It is caused by an overgrowth of the septal quadrangular cartilage. On profile, it is characterized by a convex dorsum appearance, a pseudo-droopy tip, and a short upper lip often associated to a retrogenia, so-called the “Semitic nose” type in the classic textbooks.

Recently, in 2021, guidelines in primary rhinoplasty have been published by the senior author, according to his experience in 652 consecutive primary rhinoplasties in a 6 years series study, analyzing the results through a retrospective study of the revision cases. The results show that primary rhinoplasty in TND consists in a preservation rhinoplasty “type 2”: reduction of the dorsum height through a high strip excision associated to a K-area resurfacing allowing for flattening or even curving the nasal bridge. This technique offers the best results, the less revision rate, and optimized outcomes.

Ancillary procedures may be associated to dorsum reduction and tip support: alar base reduction, upper lip cheiloplasty, and chin augmentation. These procedures are changing the patient’s profile from convex to straight, improving the facial global harmony.

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Saban, Y., Saman, M., Göksel, A. (2022). Mediterranean Noses: The Tension Nose Deformity and Preservation Rhinoplasty. In: Giacomini, P.G. (eds) Mediterranean Rhinoplasty. Springer, Cham.

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  • Print ISBN: 978-3-031-05550-8

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