Rhinoplasty: the retractable roof.

A new operative technique is described in which the natural curved nasal dorsum is retained in a modified fashion. Specifically, the nasal dorsum is elevated, the nasal height is reduced, and then the newly designed roof is lowered. Based on a minimum 1-year follow-up of 14 patients and a total experience of 28 patients, the procedure has the following advantages: (1) near normal anatomic structure is retained, (2) common secondary dorsal deformities are avoided, (3) the retained roof can function as a spreader graft, (4) the skin attachment with its attendant blood supply is preserved, and (5) the graft can be removed primarily or easily modified secondarily. Disadvantages appear to be the need for greater finesse and a limited follow-up of 2 years.