Step-up manoeuvre for radix control in dorsal preservation rhinoplasty

Introduction Radix control remains a key concern in preservation rhinoplasty. Consistent techniques for managing this area are essential for optimal outcomes. Objectives & hypotheses This article presents the step-up manoeuvre, a novel technique for precise modulation of radix height while preserving structural integrity. Study design Retrospective case series. Methods A retrospective analysis of 245 consecutive primary preservation rhinoplasties using the step-up manoeuvre between 2022 and 2023 was conducted. Results The subdorsal Tetris flap was employed in 86.1% of cases, while the low strip approach was used in 13.9%. Intraoperative outcomes included: Radix maintained - 91.0%; Radix projected - 2.9%; Radix deprojected - 6.1%. Conclusions The step-up manoeuvre represents a significant advancement in preservation rhinoplasty, broadening its indications and reducing the risk of radix-related complications. These findings suggest that preservation rhinoplasty can be safely and effectively extended to a wider range of nasal anatomies, further refining surgical strategies and reducing revision rates. KEYWORDS: rhinoplasty, preservation, step-up. ACKNOWLEDGEMENTS: Artificial intelligence (AI)-based tools were used solely to assist with English language editing and did not contribute to the conceptual or substantive content of the manuscript.