Preservation rhinoplasty lowers the bridge by taking bone from underneath and keeping the roof intact. It suits a smooth, regular hump — and it is not right for every nose.
Preservation rhinoplasty removes a strip of bone and cartilage from beneath the bridge and lets the intact roof settle downwards, instead of filing the hump off the top. Classic hump removal cuts through the dorsal surface and then rebuilds it, usually with spreader grafts, to close the flat open roof that resection leaves behind. The difference is which surfaces are disturbed: preservation keeps the natural dorsal lines and the ligaments over them, so the bridge looks untouched even though it is lower.
The technique rewards a specific anatomy: a smooth, regular hump without a wide bony base, a straight dorsum in front view, and no history of nasal fracture. Under those conditions the result can look as though the nose was simply born smaller. A crooked bridge, a very wide hump, a deep supratip break or previous surgery makes preservation much harder to control, and forcing it produces a bridge that partly rises again during the first year.
Preservation is not a newer and therefore better operation. Its main published weakness is recurrence, the hump reappearing to a degree as the released bridge finds its position, and revision afterwards is technically demanding because the anatomy no longer matches the standard map. Structural, component reduction remains the more predictable choice for crooked and complex noses, and it has three decades of documented follow-up behind it. We use both, and we say which one your photographs point to.
Both techniques are €2,900 here, covering the operation, general anaesthesia, one night of hospital care with intensive care available in the building, and the follow-up schedule. When you compare quotes, ask the surgeon to name the technique in writing and to explain why your nose needs it — a clinic that offers preservation to every patient is marketing a word, not planning an operation. Photographs and questions can go to WhatsApp on +905402555055 before you commit to anything.
Swelling over the bridge often settles a little sooner because the dorsal ligaments are kept, but tip swelling follows the same slow course as any rhinoplasty. Time off work is unchanged at roughly ten days.
A small residual bump can usually be rasped under local anaesthesia after twelve months. We would rather discuss that possibility before surgery than present it as a surprise afterwards.