Dorsal Preservation versus Conventional Hump Reduction Rhinoplasty: A Seven-Year Review of Patient Reported Outcomes and Concurrent Operative Techniques.

OBJECTIVES: To compare early and long-term patient-reported outcomes following dorsal preservation rhinoplasty (DPR) versus conventional hump reduction (CHR) in patients undergoing primary nasal dorsal reduction. METHODS: We conducted a retrospective cohort study of 377 patients who underwent DPR (n = 178) or CHR (n = 199) between 2017-2024. Outcomes were assessed using the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) and visual analog scale (VAS) scores at baseline and at 3, 6, 12, and 24 months postoperatively. Multivariate linear regression adjusted for age, sex, and baseline symptom severity. RESULTS: In unadjusted analyses, DPR was associated with lower SCHNOS-C scores and higher VAS-C scores at 3 and 6 months postoperatively compared with CHR, although the absolute differences were modest. After multivariable adjustment, DPR was independently associated with improved SCHNOS-C scores at 6 months, but not at 3 months. No significant differences in aesthetic outcomes were observed at 12 or 24 months. Functional outcomes were similar between groups across all time points. Patients who underwent CHR more frequently underwent midvault reconstruction with spreader grafts or autospreaders, anterior septal reconstruction (ASR), and clocking sutures, whereas DPR patients frequently underwent supratip, radix, and underlay articulated rim grafting. CONCLUSION: DPR was associated with modest, early improvements in patient-reported aesthetic outcomes that reached statistical significance at 6 months after adjustment, with convergence of aesthetic and functional outcomes thereafter. These findings are associative rather than causal and emphasize the importance of patient selection and underlying nasal anatomy in guiding surgical technique.Level of Evidence: 3.