Video 3.18: Dorsal Roof Technique – Radix Osteotomy and Let Up for a Low Radix

What this video shows

Video 3.18 belongs to the dorsal roof technique, the dorsum preservation method published by the author in Aesthetic Surgery Journal. In this technique the dorsal roof is separated by following the dorsal aesthetic lines rather than staying as close to the septum as possible, and the nasal bone is incised with bone scissors or a power instrument along the dorsal aesthetic lines, the so-called dorsal osteotomy, which lies more laterally than a classical medial osteotomy.

The video focuses on the radix: if the radix level is low, a full radix osteotomy is made so that a graft can be placed under it (let up); if the radix is high, the radix osteotomy is made as a greenstick fracture; if the level is normal, no radix osteotomy is needed. After this step the dorsum is separated from the septum with at least 2 mm thickness, creating the dorsal roof.

Key points

• Dorsal osteotomy follows the dorsal aesthetic lines.

• Low radix: full radix osteotomy plus let up graft. High radix: greenstick fracture.

• The dorsal roof is kept at least 2 mm thick.

In the book: Chapter 3 – Dorsum Surgery, section 3.4.2.2.2 Dorsal Roof Technique, pp. 59–62 of Rhinoplasty in Practice: An Algorithmic Approach to Modern Surgical Techniques (CRC Press, 2021). About the book and all companion videos.

Related publication record: Dorsal Roof Technique for Dorsum Preservation in Rhinoplasty.

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.