{"id":82189,"date":"2026-10-31T12:00:00","date_gmt":"2026-10-31T09:00:00","guid":{"rendered":"https:\/\/bariscakir.com\/structure-preservation-rhinoplasty\/"},"modified":"2026-11-01T10:27:30","modified_gmt":"2026-11-01T07:27:30","slug":"structure-preservation-rhinoplasty","status":"publish","type":"page","link":"https:\/\/bariscakir.com\/en\/structure-preservation-rhinoplasty\/","title":{"rendered":"Structure-Preservation Approach"},"content":{"rendered":"\t\t
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BARI\u015e \u00c7AKIR \/ RHINOPLASTY APPROACHES \/ 04<\/div>\t\t\t\t<\/div>\n\t\t\t\t
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Structure-Preservation Approach<\/h1>\t\t\t\t<\/div>\n\t\t\t\t
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Combining preservation and structural support in a single plan<\/div>\t\t\t\t<\/div>\n\t\t\t\t
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I do not describe my experience in rhinoplasty as a linear path in which I transitioned from reconstructive surgery to preservation surgery, leaving one behind. The real issue is which of the two approaches\u2019 tools we will use to address a given anatomical problem.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t

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\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tDiscover the approach \u2193<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tFrequently Asked Questions \u2193<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/section>\n\t\t
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THE FOUNDATION OF THE APPROACH<\/div>\t\t\t\t<\/div>\n\t\t\t\t
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Preserving the structure that can be preserved and restructuring the area that requires support are two complementary decisions based on the same surgical approach.<\/h2>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/section>\n\t\t
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01 \/ ANALYSIS<\/div>\t\t\t\t<\/div>\n\t\t\t\t
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Why don't I just talk about two separate methods?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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The question \u201cStructural or preservation?\u201d can serve as a starting point; however, it does not, by itself, determine the surgical plan. The nasal bridge, nasal tip, and airway may not all be equally suitable for preservation. While preserving a strong existing structure in one area, it may be necessary to re-establish inadequate support in another area.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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In the article \u201cTrial, Error, and Expertise,\u201d which we published with Erhan Co\u015fkun, we discussed our experience with structural and preservation techniques within this context of development. The publication is a retrospective evaluation of our personal surgical experience; it is not a randomized comparison demonstrating that one approach is superior in all patients. [1]<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/section>\n\t\t

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02 \/ ANALYSIS<\/div>\t\t\t\t<\/div>\n\t\t\t\t
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Structure-preservation is more of a decision-making framework than a recipe<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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By this heading, I do not mean to perform the same procedure on every patient. First, I determine which tissue is valuable in terms of its form and function, and then I determine which relationship needs to be altered. The decision to preserve and the decision to restructure are both the result of the same analysis.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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The book *Structural Preservation Rhinoplasty*, of which I am a co-editor, addresses this field with contributions from numerous surgeons. I would like to emphasize that the title and approach represent a shared body of knowledge. The convergence of diverse surgical experiences within a single resource facilitates a joint discussion of patient selection and the transition between different techniques. [2]<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/section>\n\t\t

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03 \/ ANALYSIS<\/div>\t\t\t\t<\/div>\n\t\t\t\t
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Hybrid dorsum: the ability to make adjustments while maintaining integrity<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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When discussing the preservation of the nasal bridge, the bridge\u2019s current shape must also be taken into account. A nasal bridge with issues such as width or asymmetry may not achieve the desired shape simply by reducing its height. The goal of preservation does not eliminate these issues.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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The article \u201cHybrid Dorsal Preservation Rhinoplasty,\u201d of which I am a co-author, discusses an approach that reorganizes specific features of the nasal dorsum while preserving the connections in the bone-cartilage junction\u2014referred to as the \u201ckeystone.\u201d This publication serves as a concrete example of the integration of preservation and structural reorganization within the same framework. [3]<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/section>\n\t\t

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04 \/ ANALYSIS<\/div>\t\t\t\t<\/div>\n\t\t\t\t
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Why are wide and crooked noses considered separately?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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With a large, wide, or noticeably curved nose, the issue is not simply a matter of correcting a single line. The direction of the bridge, the position of the central structures, and the balance of the lateral walls are all considered together. These characteristics can push the boundaries of a classic reconstruction plan.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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The article \u201cLibra Flap \/ Central Platform Surgery,\u201d which my colleagues and I published, presents a series of techniques targeting this decision-making area in large and deviated noses. The study reports on a retrospective experience involving 77 patients. It should not be concluded that the same technique can be applied to every deviated nose or every revision procedure. [4]<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/section>\n\t\t

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05 \/ ANALYSIS<\/div>\t\t\t\t<\/div>\n\t\t\t\t
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Different instruments for different areas during the same surgery<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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In one patient, it may be appropriate to preserve the continuity of the dorsum and provide support for the tip of the nose. In another patient, a specific portion of the dorsum may be reconstructed while utilizing the existing cartilage of the tip. The internal consistency of the plan is more important than the instruments used bearing the same label.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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This is what needs to be explained to the patient: Which part will be preserved, which part will be altered, and what is the rationale behind this decision? The significance of the technical details becomes clear when they are related to the patient\u2019s anatomy and expectations.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/section>\n\t\t

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06 \/ ANALYSIS<\/div>\t\t\t\t<\/div>\n\t\t\t\t
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Don't turn a technical choice into a promise<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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Just because a surgery is called \u201chybrid\u201d does not mean it is easier, risk-free, or more suitable for everyone. Existing loss of support, skin coverage, the septum, and previous surgeries may limit the options. The same goal may not be achieved through the same approach in every patient.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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For me, the value of this approach lies in the fact that it offers more options. The surgical plan should aim not to validate the name of the method, but to address the patient\u2019s anatomical needs. The balance between protection and support is therefore determined on a case-by-case basis.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/section>\n\t\t

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PUBLICATIONS AND BOOKS<\/div>\t\t\t\t<\/div>\n\t\t\t\t
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The scientific basis for this approach<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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You can access the relevant publications and book chapters via the links below. The scope of the studies and the applicability of each technique should be evaluated on a case-by-case basis.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t

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1 \/ 2025<\/div>\t\t\t\t<\/div>\n\t\t\t\t
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Trial, Error, and Expertise: My Evolution Through Structural and Preservation Rhinoplasty Techniques<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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Bar\u0131\u015f \u00c7ak\u0131r and Erhan Co\u015fkun \u00b7 co-authored article<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tView the publication \u2197<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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2 \/ 2025<\/div>\t\t\t\t<\/div>\n\t\t\t\t
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Structural Preservation Rhinoplasty<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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Bar\u0131\u015f \u00c7ak\u0131r \u00b7 one of seven co-editors; QMP<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tView the publication \u2197<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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3 \/ 2024<\/div>\t\t\t\t<\/div>\n\t\t\t\t
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Hybrid Dorsal Preservation Rhinoplasty: Reediting an Aesthetic Dorsum<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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Sergio Furtado, Enrico Robotti, Antonio Sousa Vieira, Bar\u0131\u015f \u00c7ak\u0131r, Dunja Milicic \u00b7 co-authored article<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tView the publication \u2197<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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4 \/ 2025 online \/ 2026<\/div>\t\t\t\t<\/div>\n\t\t\t\t
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Central Platform Surgery for Large and Deviated Noses\u2014The Libra Flap: Low Septal Strip Dorsal Y Preservation<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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Bar\u0131\u015f \u00c7ak\u0131r and his colleagues \u00b7 co-authored article<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tView the publication \u2197<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/section>\n\t\t
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COMPLEMENTARY APPROACHES<\/div>\t\t\t\t<\/div>\n\t\t\t\t
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Discover other rhinoplasty approaches<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tPreservation Rhinoplasty \u2192<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tStructural Rhinoplasty \u2192<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tFunctional Rhinoplasty \u2192<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tRevision Rhinoplasty \u2192<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/section>\n\t\t
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The approach that's right for you is determined through a personal assessment.<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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A treatment plan is developed by taking into account your nasal anatomy, your breathing difficulties, and your expectations.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tContact us \u2192<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/section>\n\t\t
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ANSWERS TO YOUR QUESTIONS<\/div>\t\t\t\t<\/div>\n\t\t\t\t
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Frequently Asked Questions<\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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Frequently Asked Questions About the Structure-Preservation Approach.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t

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Is structure-preservation a separate and standard surgical procedure?<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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It does not describe a single standard sequence of procedures. It is a decision-making approach in which protective principles and structural supports are used in combination based on the patient\u2019s anatomical needs.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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Are \u201cStructural Preservation\u201d and \u201cStructure-Preservation\u201d the same thing?<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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On this page, I use the term \u201cStructure-Preservation\u201d to refer to an approach that addresses both structure and preservation. The published title of the book I co-edited is \u201cStructural Preservation Rhinoplasty.\u201d<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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Does this approach fully preserve the bridge of the nose?<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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It may not be possible to provide the same level of protection for every patient and in every area. The width, curvature, or support issues that require replacement, as well as the connections that need to be preserved, are evaluated on a case-by-case basis.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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Is it common to use grafts in the hybrid approach?<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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Yes. Preserving the integrity of one area does not eliminate the need for support in another area. Graft requirements and sources are planned on an individual basis.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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Could it be suitable for wide or crooked noses?<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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Hybrid techniques for these anatomical variations have been published. However, the fact that such patients were identified in one study does not mean that the same method is appropriate for every nose that appears similar.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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Is the Libra Flap a standard part of every preservation surgery?<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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No. It refers to a specific technical approach for large and deviated noses. It is not a mandatory step in every corrective surgery or a universal solution for all deviations.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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Is this approach performed only through closed surgery?<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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No. Access routes and decisions regarding protection and support are distinct from one another. The choice between an open or closed approach depends on the planned procedures and the clinical evaluation.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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How do you choose a method?<\/h3>\t\t\t\t<\/div>\n\t\t\t\t
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Facial and nasal analysis, airway assessment, skin and cartilage characteristics, previous surgeries, and the patient\u2019s expectations are all considered together. The technical term takes on its meaning following this assessment.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/section>\n\t\t

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BARI\u015e \u00c7AKIR \/ N\u0130\u015eANTA\u015eI, \u0130STANBUL, T\u00dcRK\u0130YE<\/div>\t\t\t\t<\/div>\n\t\t\t\t
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Let's discuss
your questions together.<\/em><\/h2>\t\t\t\t<\/div>\n\t\t\t\t
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You can request an appointment to discuss your personal expectations and options.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t

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\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tContact \u2197<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tSchedule an Appointment \u2197<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

Rinoplastideki deneyimimi, yap\u0131sal cerrahiden koruyucu cerrahiye ge\u00e7ip birini geride b\u0131rakt\u0131\u011f\u0131m do\u011frusal bir yol olarak tarif etmiyorum. As\u0131l mesele, her ikisinin ara\u00e7lar\u0131n\u0131 hangi anatomik soruna yan\u0131t vermek i\u00e7in kullanaca\u011f\u0131m\u0131zd\u0131r.<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":4,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-82189","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/bariscakir.com\/en\/wp-json\/wp\/v2\/pages\/82189","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bariscakir.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/bariscakir.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/bariscakir.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/bariscakir.com\/en\/wp-json\/wp\/v2\/comments?post=82189"}],"version-history":[{"count":3,"href":"https:\/\/bariscakir.com\/en\/wp-json\/wp\/v2\/pages\/82189\/revisions"}],"predecessor-version":[{"id":82193,"href":"https:\/\/bariscakir.com\/en\/wp-json\/wp\/v2\/pages\/82189\/revisions\/82193"}],"wp:attachment":[{"href":"https:\/\/bariscakir.com\/en\/wp-json\/wp\/v2\/media?parent=82189"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}