The various shades of hybridism in rhinoplasty: variations on dorsal preservation and presentation of a cartilaginous push down technique

Introduction: The growing interest on preservation techniques gave rise to many variations classified under the term hybrid rhinoplasty. Objectives & Hypotheses: To specify the various meanings of hybridism in rhinoplasty tracing the term back in time, and to present our contemporary practice in the management of the middle vault. Study Design: Review of the medical literature about hybrid rhinoplasty and retrospective cohort study of patients submitted to hump reduction with cartilaginous preservation and push down. Methods: 75 patients submitted to primary rhinoplasty consisting in hump reduction with complete removal of the osseous hump and cartilaginous push down and evaluated for functionality and aesthetic satisfaction. Results: Cartilaginous push down results in great functional and aesthetic success with low rates of complications or recurrences. Conclusions: Studying the literature, we recognized three distinct entities of hybridism in rhinoplasty One of these is the variations on dorsal preservation techniques. Cartilaginous push down is a true hybrid technique standing between structural hump removal and complete dorsal preservation.