title: The pull-up spreader high (PUSH) technique for nasal tip support.
abstract: BACKGROUND
  Nasal tip depression is associated with nasal valve collapse. The pull-up spreader high (PUSH) technique was developed to enlarge the nasal dorsum and upwardly rotate and define the nasal tip by lifting the domes.
  
  
  OBJECTIVE
  The authors reviewed a case series to assess the long-term effectiveness of the PUSH technique in improving nasal airflow and aesthetic outcomes.
  
  
  METHODS
  This retrospective study included 50 consecutive cases of PUSH rhinoplasty. Objective (acoustic rhinomanometry) and subjective (patient questionnaire) evaluations of the stability of the aesthetic result and improvement of airflow were conducted before and 3 years after PUSH rhinoplasty.
  
  
  RESULTS
  PUSH rhinoplasty resulted in long-term stability of the aesthetic effect. All patients had pleasing aesthetic results and a general improvement in the nasal airway. When the degree of nasal obstruction was scored from 1 (greatest obstruction) to 10 (least obstruction), 22 patients rated their nasal function improved to a score of 10 and 28 patients to a score of 8. Rhinomanometry indicated that only 1 patient had worsened nasal airflow.
  
  
  CONCLUSIONS
  The PUSH technique enables stable upward rotation and improved definition of the severely depressed nasal tip through an open approach.
  
  
  METHODS
  4.
authors.affiliation: Dr Bertossi is an Associate Professor and Dr Nocini is the Chief of the Department of Surgery, Chief of the section of Maxillo Facial Surgery at the University of Verona in ItalyDr Walter is retired from private practice in facial plastic surgery in St Galle and Heiden, Switzerland dario.bertossi@univr.it.
authors.forename: Dario
authors.initials: D
authors.lastname: Bertossi
authors.affiliation: Dr Bertossi is an Associate Professor and Dr Nocini is the Chief of the Department of Surgery, Chief of the section of Maxillo Facial Surgery at the University of Verona in ItalyDr Walter is retired from private practice in facial plastic surgery in St Galle and Heiden, Switzerland.
authors.forename: Claus
authors.initials: C
authors.lastname: Walter
authors.affiliation: Dr Bertossi is an Associate Professor and Dr Nocini is the Chief of the Department of Surgery, Chief of the section of Maxillo Facial Surgery at the University of Verona in ItalyDr Walter is retired from private practice in facial plastic surgery in St Galle and Heiden, Switzerland.
authors.forename: Pier Francesco
authors.initials: PF
authors.lastname: Nocini
mesh_terms: D000328:Adult; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000601:surgery*; D009300:Nasal Septum / Q000601:surgery*; D012189:Retrospective Studies; D025363:Rhinomanometry / Q000379:methods / Q000706:statistics & numerical data; D012225:Rhinoplasty / Q000379:methods*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: nasal autospreaders; nasal surgery; nasal tip; pull-up spreader high