Video 3.13: Fix Up Technique – Raising a Low Radix with a Bone or Cartilage Graft

What this video shows

Not every nose treated with a preservation approach has the radix at the right level. Video 3.13 shows the fix up method: when the radix is low, a bone or cartilage graft is positioned between the nasal bones and the ethmoid bone or naso-frontal crest, which increases the height of the radix. The book relates this manoeuvre to the 'let up' concept described in the dorsum preservation literature.

Together with the back-cut and septal rotation shown in Video 3.12, this step allows the surgeon to set the whole profile, radix and dorsum, without excising the dorsal aesthetic lines.

Key points

• Indication: low radix in a preservation rhinoplasty.

• A bone or cartilage graft is placed between the nasal bones and the ethmoid bone.

• Radix height is increased while the dorsum is preserved.

In the book: Chapter 3 – Dorsum Surgery, section 3.4.2.2.1 Down Techniques – Fix Down Technique, Step 4 (fix up method), p. 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.