What I do is an adaptation of a technique called “dorsum preservation rhinoplasty”.
But there are many differences.
First of all, there is no dissection on the dorsum. I cut the entire bone structure of the nose from the side and from the top as in the classical technique using a fine-tipped micro hand saw. The bone structure that is being cut now becomes mobile and I can shake it left and right. The second step is to subtract a few millimeters from the septum, which is known as superior strip, and press this moving bone structure down into the nasal cavity.
When it reaches the level I want, I fix the whole nose with a stitch that I called “teodor suture” (teo dorsum suture) in this position. When the bone structure as a whole goes down and is fixed, it can no longer move to the left or right and it becomes unnecessary to put a cast. And this is also the reason I don’t use letdown, where the bone cannot be pushed into the nasal cavity, but floats on the surface instead.
Tip surgery is the most innovative and important part of this technique. I use a different type of tip graft, that I call “teostrut”. This single piece of cartilage gives strength to my tips so that they will never fall. This strength also allows me to change many other things in my tip surgery, it’s a long list.
In summary, this is a no dissection preservation rhinoplasty, dorsum is fixed and solid, and the tip is so strong that it will never fall in longterm. It’s an outpatient surgery without cast, splints, drains, and with shorter healing period.