Commentary on: Dorsal Preservation: The Push Down Technique Reassessed

Some time ago, in 2010, I was visiting my esteemed colleague and friend, the great Mexican functional rhinologist and cosmetic rhinoplasty surgeon, Dr Fausto Lopez Infante (1935-2013). I asked him how often he performed dorsal preservation procedures in rhinoplasty such as the push down or let down operations. He paused for not more than a blink and earnestly stated, "For the first 10 years of practice I did the Push Down; the next 10 years I chiseled off the dorsum. What do you think I did for this last 10 years?" As I remember that instant in time, I said, "You returned to the push down or let down." "Exactly," he replied, "because I loved the smooth dorsum and avoiding the postoperative disrupted K-area with the attendant dorsal irregularities. And of course, I did not like the infracture needed to close the open roof that at times narrowed the nasal valve angle and area producing postoperative breathing disturbances."