Video 3.12: Fix Down Technique – Back-Cut Incision and Septal Rotation to Treat Dorsal Curvature Without Excision

What this video shows

Video 3.12 shows the profile-setting step of the fix down technique. For dorsal curvature, a back-cut incision running from the posterior chondrotomy to under the dorsum is performed, and the septum is made to rotate on the maxillary spine to achieve anterior-caudal rotation. Because the keystone area becomes semi-mobile through the back-cut, this rotation eliminates the hump and the dorsal curvature, so the dorsum can be treated without performing any excision.

The book adds that a high dorsum can be lowered with a posterior strip excision from the base of the septum, and that any residual hump in severe curvature deformities, which is rare, can be treated with an onlay graft or partial resection.

Key points

• Back-cut incision from the posterior chondrotomy to under the dorsum.

• Anterior-caudal rotation of the septum on the maxillary spine.

• Hump and dorsal curvature corrected without dorsal excision.

In the book: Chapter 3 – Dorsum Surgery, section 3.4.2.2.1 Down Techniques – Fix Down Technique, Step 4 Profile Setting, pp. 53–54 of Rhinoplasty in Practice: An Algorithmic Approach to Modern Surgical Techniques (CRC Press, 2021). About the book and all companion videos.

Related publication record: The Alignment of the Nose in Rhinoplasty: Fix Down Concept.

Surgeon: Prof. Dr. Suleyman Tas, plastic, reconstructive and aesthetic surgeon, Istanbul. This video is part of the surgeon-training material of the book; patients considering rhinoplasty in Istanbul can use it to understand the techniques used at Prof. Dr. Suleyman Tas Clinic.